Provider Demographics
NPI:1194089607
Name:BALKH, KARINA (LMHC)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:BALKH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 BEACON ST
Mailing Address - Street 2:27
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4808
Mailing Address - Country:US
Mailing Address - Phone:617-834-8084
Mailing Address - Fax:
Practice Address - Street 1:1419 BEACON ST
Practice Address - Street 2:27
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4808
Practice Address - Country:US
Practice Address - Phone:617-834-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7499101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health