Provider Demographics
NPI:1841721792
Name:MADEIRA, KAREN (LPC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MADEIRA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 OLEY RD
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-8861
Mailing Address - Country:US
Mailing Address - Phone:610-207-5279
Mailing Address - Fax:
Practice Address - Street 1:3459 PENN AVE # 2
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1194
Practice Address - Country:US
Practice Address - Phone:610-207-5279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2019-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005422101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional