Provider Demographics
NPI:1518328319
Name:EADS, KARA (LMHC)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:EADS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 36TH ST # 208
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6580
Mailing Address - Country:US
Mailing Address - Phone:360-922-4747
Mailing Address - Fax:360-483-5142
Practice Address - Street 1:87 SUDDEN VALLEY DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-7741
Practice Address - Country:US
Practice Address - Phone:360-922-4747
Practice Address - Fax:360-483-5142
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 101Y00000X
WA60877634101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2105810Medicaid