Provider Demographics
NPI:1750321782
Name:SCHARA, KATHLEEN R (PSYD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:R
Last Name:SCHARA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 S OAK ST
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2614
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:126 E ALCOTT AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2903
Practice Address - Country:US
Practice Address - Phone:218-736-6987
Practice Address - Fax:218-736-6980
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2028103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN00570026OtherPREFERREDONE
MN106245OtherUCARE MINNESOTA
MN61-01235OtherUNITED BEHAVIORAL HEALTH
MN11R70SCOtherBLUE SHIELD OF MINNESOTA
MNHP17564OtherHEALTHPARTNERS