Provider Demographics
NPI:1871984534
Name:KARVINEN COUNSELING SERVICES, PC
Entity type:Organization
Organization Name:KARVINEN COUNSELING SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARVINEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LCPC, CADC
Authorized Official - Phone:618-659-5411
Mailing Address - Street 1:2220 S STATE ROUTE 157
Mailing Address - Street 2:SUITE 200D
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-1724
Mailing Address - Country:US
Mailing Address - Phone:618-659-5411
Mailing Address - Fax:618-659-5411
Practice Address - Street 1:2220 S STATE ROUTE 157
Practice Address - Street 2:SUITE 200D
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-1724
Practice Address - Country:US
Practice Address - Phone:618-659-5411
Practice Address - Fax:618-659-5411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL15725101YA0400X
IL19943101YA0400X
IL178000692101YM0800X
IL180003528101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty