Provider Demographics
NPI:1659492437
Name:DAUGHERTY, KARA L (MSW)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:L
Last Name:DAUGHERTY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13106 N BECKS GROVE DR
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-8369
Mailing Address - Country:US
Mailing Address - Phone:317-856-4608
Mailing Address - Fax:
Practice Address - Street 1:650 E SOUTHPORT RD
Practice Address - Street 2:SUITE C
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-8592
Practice Address - Country:US
Practice Address - Phone:317-783-8383
Practice Address - Fax:317-782-6929
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker