Provider Demographics
NPI:1982630265
Name:COURCHAINE, KAREN E (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:E
Last Name:COURCHAINE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 S MARION AVE
Mailing Address - Street 2:NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-5808
Mailing Address - Country:US
Mailing Address - Phone:386-755-3016
Mailing Address - Fax:386-754-7370
Practice Address - Street 1:619 S MARION AVE
Practice Address - Street 2:NORTH FLORIDA/SOUTH GEORGIA VETERANS HEALTH SYSTEM
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-5808
Practice Address - Country:US
Practice Address - Phone:386-755-3016
Practice Address - Fax:386-754-7370
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5513103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist