Provider Demographics
NPI:1104188895
Name:KONTOULAS, LOULA KARRAS (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:LOULA
Middle Name:KARRAS
Last Name:KONTOULAS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5913 COLCHESTER PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-5403
Mailing Address - Country:US
Mailing Address - Phone:704-622-7847
Mailing Address - Fax:
Practice Address - Street 1:711 E MOREHEAD ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2739
Practice Address - Country:US
Practice Address - Phone:980-442-0941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-09
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1552106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist