Provider Demographics
NPI:1063698694
Name:BRAUER, KAREN FAYE (LCPC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:FAYE
Last Name:BRAUER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 530
Mailing Address - Street 2:
Mailing Address - City:HAVANA
Mailing Address - State:IL
Mailing Address - Zip Code:62644-0530
Mailing Address - Country:US
Mailing Address - Phone:309-543-6600
Mailing Address - Fax:309-543-2089
Practice Address - Street 1:615 N PROMENADE ST
Practice Address - Street 2:
Practice Address - City:HAVANA
Practice Address - State:IL
Practice Address - Zip Code:62644-1243
Practice Address - Country:US
Practice Address - Phone:309-543-6600
Practice Address - Fax:309-543-2089
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006161101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional