Provider Demographics
NPI:1922109990
Name:HUBBARD, KARA J (LCPC, LAC)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:J
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:LCPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E BROADWAY ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4532
Mailing Address - Country:US
Mailing Address - Phone:406-728-1016
Mailing Address - Fax:
Practice Address - Street 1:101 E BROADWAY ST
Practice Address - Street 2:SUITE 407
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4532
Practice Address - Country:US
Practice Address - Phone:406-728-1016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1039101YA0400X
MT1199101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0256893Medicaid