Provider Demographics
NPI:1972144202
Name:KARP, EMALIE ELIZABETH (LLMSW)
Entity type:Individual
Prefix:
First Name:EMALIE
Middle Name:ELIZABETH
Last Name:KARP
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:EMALIE
Other - Middle Name:E
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:PO BOX 13008
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48901-3008
Mailing Address - Country:US
Mailing Address - Phone:517-253-6320
Mailing Address - Fax:517-253-6321
Practice Address - Street 1:800 E COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-1381
Practice Address - Country:US
Practice Address - Phone:517-244-8940
Practice Address - Fax:517-244-8941
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801117021OtherMI PROFESSIONAL LICENSE