Provider Demographics
NPI:1083160097
Name:HOLCOMB, KARA MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 S AIRPORT RD W
Mailing Address - Street 2:STE 7B
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7928
Mailing Address - Country:US
Mailing Address - Phone:231-715-8466
Mailing Address - Fax:231-943-2263
Practice Address - Street 1:3335 S AIRPORT RD W
Practice Address - Street 2:STE 7B
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7928
Practice Address - Country:US
Practice Address - Phone:231-715-8466
Practice Address - Fax:231-943-2263
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011002121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical