Provider Demographics
NPI:1700848108
Name:CORRIVEAU, KAREN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:CORRIVEAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 WEST OAK STREET
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525
Mailing Address - Country:US
Mailing Address - Phone:970-494-4300
Mailing Address - Fax:970-494-4301
Practice Address - Street 1:525 W OAK ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2612
Practice Address - Country:US
Practice Address - Phone:970-494-4300
Practice Address - Fax:970-494-4301
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO991485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC356798Medicare PIN