Provider Demographics
NPI:1912085028
Name:THEISEN, KAREN (LLPC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:THEISEN
Suffix:
Gender:
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S SHORE DR UNIT 224
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5440
Mailing Address - Country:US
Mailing Address - Phone:269-979-8119
Mailing Address - Fax:269-979-8124
Practice Address - Street 1:601 S SHORE DR UNIT 224
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5440
Practice Address - Country:US
Practice Address - Phone:269-979-8119
Practice Address - Fax:269-979-8124
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009422101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional