Provider Demographics
NPI:1265748099
Name:WOLFRAM, KAREN L (LPC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:WOLFRAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:96 BLUE SPRUCE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122
Mailing Address - Country:US
Mailing Address - Phone:970-250-7775
Mailing Address - Fax:970-874-0464
Practice Address - Street 1:115 GRAND AVE, SUITE 2
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416
Practice Address - Country:US
Practice Address - Phone:970-874-0464
Practice Address - Fax:970-874-0464
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2683101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health