Provider Demographics
NPI:1770134991
Name:JAKUBEC, KARA (MED, LPC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:JAKUBEC
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:KLIESING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, LPC
Mailing Address - Street 1:1336 COUNTY ROAD 23
Mailing Address - Street 2:
Mailing Address - City:DAMON
Mailing Address - State:TX
Mailing Address - Zip Code:77430-0048
Mailing Address - Country:US
Mailing Address - Phone:281-787-0768
Mailing Address - Fax:
Practice Address - Street 1:1336 COUNTY ROAD 23
Practice Address - Street 2:
Practice Address - City:DAMON
Practice Address - State:TX
Practice Address - Zip Code:77430-0048
Practice Address - Country:US
Practice Address - Phone:281-787-0768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-28
Last Update Date:2019-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional