Provider Demographics
NPI:1134452345
Name:BERTHEL, KARA LYN
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:LYN
Last Name:BERTHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 N. MAIN ST. UNIT 4
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-0000
Mailing Address - Country:US
Mailing Address - Phone:603-898-4182
Mailing Address - Fax:
Practice Address - Street 1:50 N MAIN ST APT 4
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2430
Practice Address - Country:US
Practice Address - Phone:603-898-4182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker