Provider Demographics
NPI:1063644516
Name:SPAIN, KARA (LPC)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:SPAIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 GOLDEN HORSESHOE CIR
Mailing Address - Street 2:APT. H
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7649
Mailing Address - Country:US
Mailing Address - Phone:919-949-0983
Mailing Address - Fax:
Practice Address - Street 1:2400 GOLDEN HORSESHOE CIR
Practice Address - Street 2:APT. H
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-7649
Practice Address - Country:US
Practice Address - Phone:919-949-0983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7882101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7882OtherLICENSED PROFESSIONAL COUNSELOR