Provider Demographics
NPI:1124128897
Name:MASSOLL, KAREN J (LPC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:MASSOLL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2395 JOLLY RD STE 195
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-5987
Mailing Address - Country:US
Mailing Address - Phone:517-336-4335
Mailing Address - Fax:517-336-0101
Practice Address - Street 1:2395 JOLLY RD STE 195
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-5987
Practice Address - Country:US
Practice Address - Phone:517-336-4335
Practice Address - Fax:517-336-0101
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401003482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional