Provider Demographics
NPI:1558107250
Name:CARRIE, KAREN (LMFT, LPCC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CARRIE
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MAIN ST # 1855
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-2937
Mailing Address - Country:US
Mailing Address - Phone:650-405-9805
Mailing Address - Fax:
Practice Address - Street 1:900 N SAN ANTONIO RD STE 210
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-1307
Practice Address - Country:US
Practice Address - Phone:650-405-9805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13916101YM0800X
CA133973106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health