Provider Demographics
NPI:1992023238
Name:FOCKE, KARIN CHARLOTTE (LCPC)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:CHARLOTTE
Last Name:FOCKE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 SAINT ELMO AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3009
Mailing Address - Country:US
Mailing Address - Phone:301-325-5257
Mailing Address - Fax:
Practice Address - Street 1:4809 SAINT ELMO AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3009
Practice Address - Country:US
Practice Address - Phone:301-325-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC 1993101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional