Provider Demographics
NPI:1780138206
Name:WINEGAR, KARL (LCSW)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:WINEGAR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37283 SWAMP RD STE 803
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3329
Mailing Address - Country:US
Mailing Address - Phone:208-821-1032
Mailing Address - Fax:
Practice Address - Street 1:37283 SWAMP RD STE 803
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3329
Practice Address - Country:US
Practice Address - Phone:208-821-1032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-360011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical