Provider Demographics
NPI:1881754323
Name:PECK, KAREN LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:PECK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11378 W HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:STIGLER
Mailing Address - State:OK
Mailing Address - Zip Code:74462-3609
Mailing Address - Country:US
Mailing Address - Phone:409-409-0115
Mailing Address - Fax:539-399-7531
Practice Address - Street 1:109 E MAIN ST UNIT D
Practice Address - Street 2:
Practice Address - City:STIGLER
Practice Address - State:OK
Practice Address - Zip Code:74462-2704
Practice Address - Country:US
Practice Address - Phone:918-442-9847
Practice Address - Fax:239-399-7531
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000325101YA0400X
OK10666101YP2500X
VA0701006739101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)