Provider Demographics
NPI:1881941284
Name:RABY, KAREN MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:RABY
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 1:6104 MADDOX BLVD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-8561
Mailing Address - Country:US
Mailing Address - Phone:502-500-0310
Mailing Address - Fax:502-690-6708
Practice Address - Street 1:4934 BROWNSBORO ROAD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-6438
Practice Address - Country:US
Practice Address - Phone:502-500-0310
Practice Address - Fax:502-690-6708
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10-24106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100376400Medicaid