Provider Demographics
NPI:1407138092
Name:EBERLE, KARA DIANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KARA
Middle Name:DIANNE
Last Name:EBERLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FARLEY CIR STE 105
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9252
Mailing Address - Country:US
Mailing Address - Phone:570-847-4623
Mailing Address - Fax:570-524-0956
Practice Address - Street 1:115 FARLEY CIR STE 105
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9252
Practice Address - Country:US
Practice Address - Phone:570-524-0909
Practice Address - Fax:570-524-0956
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0212121041C0700X
PASW127219106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist