Provider Demographics
NPI:1184995706
Name:MAGILL, KARA M (LCSW)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:M
Last Name:MAGILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:M
Other - Last Name:MAGILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2011 COMMERCE DR N
Mailing Address - Street 2:SUITE D106
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3538
Mailing Address - Country:US
Mailing Address - Phone:404-953-5279
Mailing Address - Fax:678-894-8472
Practice Address - Street 1:2011 COMMERCE DR N
Practice Address - Street 2:SUITE D106
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3538
Practice Address - Country:US
Practice Address - Phone:404-953-5279
Practice Address - Fax:678-894-8472
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW004551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health