Provider Demographics
NPI:1326547118
Name:GASPERONE, KARA (LMFT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:GASPERONE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:GASPERONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3821 N 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-5545
Mailing Address - Country:US
Mailing Address - Phone:602-292-0973
Mailing Address - Fax:
Practice Address - Street 1:3821 N 15TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-5545
Practice Address - Country:US
Practice Address - Phone:602-292-0973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2021-06-10
Deactivation Date:2021-02-24
Deactivation Code:
Reactivation Date:2021-05-18
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-15136106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist