Provider Demographics
NPI:1811505357
Name:KAREN COULAM, MSW, LCSW, COUNSELING SERVICES
Entity type:Organization
Organization Name:KAREN COULAM, MSW, LCSW, COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:COULAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-663-2195
Mailing Address - Street 1:460 N 1250 E
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-2700
Mailing Address - Country:US
Mailing Address - Phone:801-663-2195
Mailing Address - Fax:
Practice Address - Street 1:96 N 500 W
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-7078
Practice Address - Country:US
Practice Address - Phone:801-692-7292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty