Provider Demographics
NPI:1316535438
Name:LIMA, CARA (MA MFT)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:LIMA
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6494
Mailing Address - Country:US
Mailing Address - Phone:704-397-7100
Mailing Address - Fax:
Practice Address - Street 1:226 BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3110
Practice Address - Country:US
Practice Address - Phone:704-975-1242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12261A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
85-2593438OtherINTERNAL REVENUE SERVICE