Provider Demographics
NPI:1982250619
Name:BROSKI, KAREN (MA, LLPC, NT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BROSKI
Suffix:
Gender:F
Credentials:MA, LLPC, NT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12477 BUGLE LK DR
Mailing Address - Street 2:
Mailing Address - City:BRUCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48065-2653
Mailing Address - Country:US
Mailing Address - Phone:586-876-2666
Mailing Address - Fax:
Practice Address - Street 1:145 ROCHDALE DR S
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-2275
Practice Address - Country:US
Practice Address - Phone:586-876-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016988101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor