Provider Demographics
NPI:1346367786
Name:WELSH, KAREN J (LCPC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:WELSH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 S MILWAUKEE AVE
Mailing Address - Street 2:SUITE 213
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3793
Mailing Address - Country:US
Mailing Address - Phone:847-212-6797
Mailing Address - Fax:847-316-9809
Practice Address - Street 1:1590 S MILWAUKEE AVE
Practice Address - Street 2:SUITE 213
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3793
Practice Address - Country:US
Practice Address - Phone:847-212-6797
Practice Address - Fax:847-316-9809
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health