Provider Demographics
NPI:1578946984
Name:PROSEN, KAREN (LMFT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PROSEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 ROSS RD UNIT 413
Mailing Address - Street 2:
Mailing Address - City:GRATON
Mailing Address - State:CA
Mailing Address - Zip Code:95444-5702
Mailing Address - Country:US
Mailing Address - Phone:707-861-1108
Mailing Address - Fax:
Practice Address - Street 1:6741 SEBASTOPOL AVE STE 160
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-3857
Practice Address - Country:US
Practice Address - Phone:707-861-1108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist