Provider Demographics
NPI:1487888590
Name:FIELDS, KARIN GRACE (LMHC)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:GRACE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4723 NW 53RD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-4804
Mailing Address - Country:US
Mailing Address - Phone:352-235-9006
Mailing Address - Fax:
Practice Address - Street 1:4703 NW 53RD AVE
Practice Address - Street 2:SUITE A-2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-3415
Practice Address - Country:US
Practice Address - Phone:352-332-6131
Practice Address - Fax:352-332-6263
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10065101YM0800X
225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor