Provider Demographics
NPI:1801291158
Name:WIND, KAREN (MA, LPC, NCC, CSOTS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WIND
Suffix:
Gender:F
Credentials:MA, LPC, NCC, CSOTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 E MISSOURI AVE
Mailing Address - Street 2:SUITE 780
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2718
Mailing Address - Country:US
Mailing Address - Phone:602-777-6156
Mailing Address - Fax:
Practice Address - Street 1:1130 E MISSOURI AVE
Practice Address - Street 2:SUITE 780
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2718
Practice Address - Country:US
Practice Address - Phone:602-777-6156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 13852101YP2500X
KS2498101YP2500X
IDLCPC-5212101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional