Provider Demographics
NPI:1649716283
Name:GRECO, KARA LEE (MA, LMHCA)
Entity type:Individual
Prefix:MS
First Name:KARA
Middle Name:LEE
Last Name:GRECO
Suffix:
Gender:F
Credentials:MA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11724 MADERA DR SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-1483
Mailing Address - Country:US
Mailing Address - Phone:253-227-2179
Mailing Address - Fax:
Practice Address - Street 1:1204 4TH AVE E
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4277
Practice Address - Country:US
Practice Address - Phone:253-227-2179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60648234101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health