Provider Demographics
NPI:1114395910
Name:ANGLIN, KARA (LSCW)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:ANGLIN
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:J
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1610 FRIAR LN APT 102
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-5873
Mailing Address - Country:US
Mailing Address - Phone:336-587-3164
Mailing Address - Fax:
Practice Address - Street 1:1610 FRIAR LN APT 102
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5873
Practice Address - Country:US
Practice Address - Phone:336-587-3164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-10
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0106251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical