Provider Demographics
NPI:1467348839
Name:ADDIS, CARA (LPC, ATR-BC)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:ADDIS
Suffix:
Gender:F
Credentials:LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 HERMITAGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2603
Mailing Address - Country:US
Mailing Address - Phone:724-713-1503
Mailing Address - Fax:
Practice Address - Street 1:1100 ADAMS AVE STE 100
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-2404
Practice Address - Country:US
Practice Address - Phone:610-277-3715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017256101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional