Provider Demographics
NPI:1073651402
Name:KITCHIN, KARA MICHELE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:MICHELE
Last Name:KITCHIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 VINE ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6028
Mailing Address - Country:US
Mailing Address - Phone:207-659-4218
Mailing Address - Fax:
Practice Address - Street 1:33 VINE ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6028
Practice Address - Country:US
Practice Address - Phone:207-659-4218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC100601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical