Provider Demographics
NPI:1457944563
Name:MACOOL, KARA LEIGH (MS, LPC, LBS)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LEIGH
Last Name:MACOOL
Suffix:
Gender:F
Credentials:MS, LPC, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-1808
Mailing Address - Country:US
Mailing Address - Phone:215-868-9586
Mailing Address - Fax:
Practice Address - Street 1:8540 VERREE RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-1399
Practice Address - Country:US
Practice Address - Phone:215-701-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009897101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health