Provider Demographics
NPI:1700947496
Name:AUGUSTYN, KAREN (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:AUGUSTYN
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:WRIGHT-AUGUSTYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 WHITELAW AVE
Mailing Address - Street 2:
Mailing Address - City:WOOD RIVER
Mailing Address - State:IL
Mailing Address - Zip Code:62095-1911
Mailing Address - Country:US
Mailing Address - Phone:618-251-4225
Mailing Address - Fax:618-251-4586
Practice Address - Street 1:114 WHITELAW AVE
Practice Address - Street 2:
Practice Address - City:WOOD RIVER
Practice Address - State:IL
Practice Address - Zip Code:62095-1911
Practice Address - Country:US
Practice Address - Phone:618-251-4225
Practice Address - Fax:618-251-4586
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional