Karen D Kornelsen, LPC INTERN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

80417 Issued in TX

Practice address

2150 Lakeside Blvd Ste 100
Richardson, TX 75082-4302

Phone

(888) 725-4642

NPI assigned

Oct 17, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1386110278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 W CAMP WISDOM RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752365629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 LAKESIDE BLVD STE 100",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750824302",
            "telephone_number": "888-725-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNELSEN",
        "first_name": "KAREN",
        "middle_name": "D",
        "credential": "LPC INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "80417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC INTERN",
            "identifier": "80417",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Kong, MD
• Dora M Kopoi
• Lawrence Jay Korenman, D.D.S.
• Kori Kind Helpers LLC
• Angie Koriakos, DO
• Divya Korrapati
• McKenzie Marie Koshi
• Suja Koshy, PTA
• Khaled Kotb
• Niharika Kothapalli

• Mental Health Counselor in Richardson, TX
• Providers in Richardson, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.