Provider Demographics
NPI:1073329744
Name:SVOBODA, KARIE LYNN (LPCC)
Entity type:Individual
Prefix:
First Name:KARIE
Middle Name:LYNN
Last Name:SVOBODA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 KINGWOOD ST STE 127
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-3452
Mailing Address - Country:US
Mailing Address - Phone:218-203-0307
Mailing Address - Fax:
Practice Address - Street 1:1001 KINGWOOD ST STE 127
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-3452
Practice Address - Country:US
Practice Address - Phone:218-203-0307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4741101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health