Provider Demographics
NPI:1104248335
Name:GONZALES, KARI L (MA LPC)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:L
Last Name:GONZALES
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:L
Other - Last Name:SHOEMAKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:420 NORTH 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-1523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 N 8TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3307
Practice Address - Country:US
Practice Address - Phone:913-568-3331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COLPC.0012723101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health