Provider Demographics
NPI:1528427465
Name:MICHELSON, KAREN A (LPC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:MICHELSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1428
Mailing Address - Country:US
Mailing Address - Phone:914-261-6282
Mailing Address - Fax:
Practice Address - Street 1:3875 BIRCHWOOD DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1428
Practice Address - Country:US
Practice Address - Phone:914-261-6282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-21
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18007082101YM0800X
CO0013331101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health