Provider Demographics
NPI:1619551363
Name:CONSTANTINE, KARA LYNN (PHD, NCSP)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:LYNN
Last Name:CONSTANTINE
Suffix:
Gender:F
Credentials:PHD, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 OLD EAGLE SCHOOL RD STE 1205
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1805
Mailing Address - Country:US
Mailing Address - Phone:586-907-0491
Mailing Address - Fax:
Practice Address - Street 1:998 OLD EAGLE SCHOOL RD STE 1205
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1805
Practice Address - Country:US
Practice Address - Phone:586-907-0491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018850103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist