Provider Demographics
NPI:1487142881
Name:GOLBERG, KARINA J (MA, LPCC)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:J
Last Name:GOLBERG
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 W 36TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-3974
Mailing Address - Country:US
Mailing Address - Phone:651-425-1561
Mailing Address - Fax:
Practice Address - Street 1:8700 W 36TH ST STE 109
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-3974
Practice Address - Country:US
Practice Address - Phone:651-425-1561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1798101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty