Provider Demographics
NPI:1457358384
Name:ALDRICH, KARLEEN ANN (LPC)
Entity Type:Individual
Prefix:
First Name:KARLEEN
Middle Name:ANN
Last Name:ALDRICH
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 1:1500 W WILLIAM CANNON DR
Mailing Address - Street 2:#209
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3182
Mailing Address - Country:US
Mailing Address - Phone:512-804-2744
Mailing Address - Fax:
Practice Address - Street 1:4201 MARATHON BLVD
Practice Address - Street 2:SUITE305
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3436
Practice Address - Country:US
Practice Address - Phone:512-627-6410
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional