Provider Demographics
NPI:1518621440
Name:KARA BOLES, PLLC
Entity Type:Organization
Organization Name:KARA BOLES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, RPT
Authorized Official - Phone:860-605-6909
Mailing Address - Street 1:22 ELM ST
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06779-2233
Mailing Address - Country:US
Mailing Address - Phone:860-605-6909
Mailing Address - Fax:
Practice Address - Street 1:22 ELM ST
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:CT
Practice Address - Zip Code:06779-2233
Practice Address - Country:US
Practice Address - Phone:860-605-6909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty