Provider Demographics
NPI:1194332288
Name:CLONINGER, KAREN H (LMHC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:H
Last Name:CLONINGER
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 1:1215 HILL STREAM DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:FL
Mailing Address - Zip Code:32732-9612
Mailing Address - Country:US
Mailing Address - Phone:407-353-5914
Mailing Address - Fax:407-349-3243
Practice Address - Street 1:122 N 4TH ST STE 2006
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2944
Practice Address - Country:US
Practice Address - Phone:407-353-5914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10281101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health