Provider Demographics
NPI:1295316495
Name:FENSTERMAKER, KARLEE P (LPC)
Entity type:Individual
Prefix:
First Name:KARLEE
Middle Name:P
Last Name:FENSTERMAKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KARLEE
Other - Middle Name:P
Other - Last Name:BRICELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4102 GREENMONT DR SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2614
Mailing Address - Country:US
Mailing Address - Phone:330-718-1061
Mailing Address - Fax:
Practice Address - Street 1:4102 GREENMONT DR SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2614
Practice Address - Country:US
Practice Address - Phone:330-718-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
OHC.2204109101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator