Provider Demographics
NPI:1255546636
Name:RICHARDSON, KAREN BROOKS (LPC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:BROOKS
Last Name:RICHARDSON
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 1:1401 LONG ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-2541
Mailing Address - Country:US
Mailing Address - Phone:336-387-6161
Mailing Address - Fax:336-387-9167
Practice Address - Street 1:1401 LONG ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2541
Practice Address - Country:US
Practice Address - Phone:336-387-6161
Practice Address - Fax:336-387-9167
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5230101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5230OtherLPC