Provider Demographics
NPI:1396301966
Name:ROY, KAREN (LCMHC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ROY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 MOUNT PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-1136
Mailing Address - Country:US
Mailing Address - Phone:603-728-8386
Mailing Address - Fax:
Practice Address - Street 1:158 MOUNT PLEASANT ST
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-1136
Practice Address - Country:US
Practice Address - Phone:603-728-8386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-19
Last Update Date:2021-02-01
Deactivation Date:2019-05-20
Deactivation Code:
Reactivation Date:2019-06-06
Provider Licenses
StateLicense IDTaxonomies
NH2194101YM0800X
VT.68.0134145101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health