Provider Demographics
NPI:1841594348
Name:EDMOND, CARA M (LMSW)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:M
Last Name:EDMOND
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 SILVER QUAIL LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5821
Mailing Address - Country:US
Mailing Address - Phone:512-470-6659
Mailing Address - Fax:
Practice Address - Street 1:903 SILVER QUAIL LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5821
Practice Address - Country:US
Practice Address - Phone:512-470-6659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51111171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator