Provider Demographics
NPI:1710290937
Name:PERNO, KARA (LCSW)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:PERNO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:SENECO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:82 ROSE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4028
Mailing Address - Country:US
Mailing Address - Phone:203-530-8744
Mailing Address - Fax:
Practice Address - Street 1:82 ROSE HILL RD
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4028
Practice Address - Country:US
Practice Address - Phone:203-530-8744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0063521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004039244Medicaid