Provider Demographics
NPI:1942807326
Name:RAWE, KAREN DEANNA (CAC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:DEANNA
Last Name:RAWE
Suffix:
Gender:F
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 FRENCH ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-6049
Mailing Address - Country:US
Mailing Address - Phone:373-983-6816
Mailing Address - Fax:
Practice Address - Street 1:1720 LAKEPOINTE DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-6458
Practice Address - Country:US
Practice Address - Phone:469-470-4878
Practice Address - Fax:214-853-9018
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC24597OtherNCSAPPB ID