Provider Demographics
NPI:1770074833
Name:DIAL, KARA A (LCSW)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:A
Last Name:DIAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:A
Other - Last Name:SHAUGHNESSY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 31022
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-0022
Mailing Address - Country:US
Mailing Address - Phone:314-275-0617
Mailing Address - Fax:314-328-5489
Practice Address - Street 1:10820 SUNSET OFFICE DR STE 220
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1030
Practice Address - Country:US
Practice Address - Phone:314-275-0617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170424091041C0700X, 101YA0400X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator