Provider Demographics
NPI:1316339997
Name:ROBERTSON, KAREN (LMSW-C)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:LMSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 MONROE AVE NW APT 313
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-1439
Mailing Address - Country:US
Mailing Address - Phone:989-600-1307
Mailing Address - Fax:616-469-1169
Practice Address - Street 1:50 LOUIS ST NW STE 610
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2645
Practice Address - Country:US
Practice Address - Phone:616-326-1074
Practice Address - Fax:616-469-1169
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801097638101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health