Provider Demographics
NPI:1811265994
Name:SUTHERLAND, KAREN V (LMFT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:V
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1496 POPE CT
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-5302
Mailing Address - Country:US
Mailing Address - Phone:219-250-2157
Mailing Address - Fax:219-250-2158
Practice Address - Street 1:1496 POPE CT
Practice Address - Street 2:SUITE 2
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-5302
Practice Address - Country:US
Practice Address - Phone:219-250-2157
Practice Address - Fax:219-250-2158
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001755A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist