Provider Demographics
NPI:1548258148
Name:CANFIELD, KAREN J (LCPC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:J
Last Name:CANFIELD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 COLLISTER DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-3721
Mailing Address - Country:US
Mailing Address - Phone:208-336-5720
Mailing Address - Fax:
Practice Address - Street 1:4720 COLLISTER DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-3721
Practice Address - Country:US
Practice Address - Phone:208-336-5720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-3319101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional