Provider Demographics
NPI:1396900858
Name:ANDERSON, KAREN SUE (MA,LMHC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1771
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-0290
Mailing Address - Country:US
Mailing Address - Phone:360-580-1011
Mailing Address - Fax:
Practice Address - Street 1:100 S I ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-6502
Practice Address - Country:US
Practice Address - Phone:360-580-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health