Provider Demographics
NPI:1508163825
Name:SANFILIPPO, CARA ROSE (NCC, LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:ROSE
Last Name:SANFILIPPO
Suffix:
Gender:F
Credentials:NCC, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MAHANTONGO ST
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3010
Mailing Address - Country:US
Mailing Address - Phone:570-622-6417
Mailing Address - Fax:
Practice Address - Street 1:221 MAHANTONGO ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3010
Practice Address - Country:US
Practice Address - Phone:570-622-6417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004596101YM0800X
PAPC005317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health