Provider Demographics
NPI:1801267224
Name:MCKEAN, KARIN (MA)
Entity type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:
Last Name:MCKEAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:
Other - Last Name:PAWLOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:605 S 3RD AVE STE AA
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-8541
Mailing Address - Country:US
Mailing Address - Phone:231-796-1583
Mailing Address - Fax:231-796-4083
Practice Address - Street 1:605 S 3RD AVE STE AA
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-8541
Practice Address - Country:US
Practice Address - Phone:231-796-1583
Practice Address - Fax:231-796-4083
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016370103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling