Provider Demographics
NPI:1902915523
Name:THEILING, KAREN M (LMHC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:THEILING
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 ROUNDHOUSE PLZ
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-4401
Mailing Address - Country:US
Mailing Address - Phone:413-522-6868
Mailing Address - Fax:413-586-0620
Practice Address - Street 1:1 ROUNDHOUSE PLZ
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-4401
Practice Address - Country:US
Practice Address - Phone:413-522-6868
Practice Address - Fax:413-586-0620
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA5192101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1902915523OtherBMC HEALTHNET PLAN
MA7767566OtherAETNA
MA1323839OtherCOMPSYCH HMO
MA1902915523OtherCOMMONWEALTH CARE MCO/BMCHP
MALM1149OtherBLUE CROSS BLUE SHIELD