Provider Demographics
NPI:1851624357
Name:RUSSO, KAREN SPAKO (LPC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SPAKO
Last Name:RUSSO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 CARMENERE DR
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-1151
Mailing Address - Country:US
Mailing Address - Phone:504-467-9858
Mailing Address - Fax:
Practice Address - Street 1:8509 OAK ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-1255
Practice Address - Country:US
Practice Address - Phone:504-669-5647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3626101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional