Provider Demographics
NPI:1215494323
Name:YAMALIS, KAREN LEBLANC (LPC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LEBLANC
Last Name:YAMALIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 PEPIN LN
Mailing Address - Street 2:
Mailing Address - City:EAST BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06023-1051
Mailing Address - Country:US
Mailing Address - Phone:860-573-3535
Mailing Address - Fax:
Practice Address - Street 1:35 COLD SPRING RD STE 124
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3161
Practice Address - Country:US
Practice Address - Phone:860-573-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional