Provider Demographics
NPI:1740432855
Name:CRAIN, KARA RENEE (MS)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:RENEE
Last Name:CRAIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1900 SILVER LAKE ROAD NW
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112
Mailing Address - Country:US
Mailing Address - Phone:651-379-1764
Mailing Address - Fax:651-379-1738
Practice Address - Street 1:1900 SILVER LAKE ROAD NW
Practice Address - Street 2:SUITE 110
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112
Practice Address - Country:US
Practice Address - Phone:651-628-9566
Practice Address - Fax:651-628-0411
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA095044101YP2500X
IL178005000101YP2500X
MNCC00249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional