Provider Demographics
NPI:1013214873
Name:CYR, KARA (CADC, MHRT-C)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:CYR
Suffix:
Gender:F
Credentials:CADC, MHRT-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIMESTONE
Mailing Address - State:ME
Mailing Address - Zip Code:04750-6607
Mailing Address - Country:US
Mailing Address - Phone:207-325-4727
Mailing Address - Fax:207-325-4308
Practice Address - Street 1:382 MAIN ST
Practice Address - Street 2:
Practice Address - City:LIMESTONE
Practice Address - State:ME
Practice Address - Zip Code:04750-6607
Practice Address - Country:US
Practice Address - Phone:207-325-4727
Practice Address - Fax:207-325-4308
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MECAC5000101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME103850000Medicaid