Provider Demographics
NPI:1306927538
Name:BRINKMAN, KAREN LEE (MS, LP, LPCC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LEE
Last Name:BRINKMAN
Suffix:
Gender:F
Credentials:MS, LP, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 443
Mailing Address - Street 2:308 10TH ST SUITE A
Mailing Address - City:WINDOM
Mailing Address - State:MN
Mailing Address - Zip Code:56101-0443
Mailing Address - Country:US
Mailing Address - Phone:507-831-4699
Mailing Address - Fax:507-831-4755
Practice Address - Street 1:308 10TH ST
Practice Address - Street 2:SUITE A,
Practice Address - City:WINDOM
Practice Address - State:MN
Practice Address - Zip Code:56101-0443
Practice Address - Country:US
Practice Address - Phone:507-831-4699
Practice Address - Fax:507-831-4755
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00130101YP2500X
MNLP3769103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7758138000Medicaid
MN7758138000Medicaid