Provider Demographics
NPI:1821380817
Name:OSTERSON, CARA PATRICIA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:PATRICIA
Last Name:OSTERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 E SCHNEIDMILLER AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-7085
Mailing Address - Country:US
Mailing Address - Phone:208-619-0190
Mailing Address - Fax:208-619-0196
Practice Address - Street 1:1700 E SCHNEIDMILLER AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7085
Practice Address - Country:US
Practice Address - Phone:208-619-0190
Practice Address - Fax:208-619-0196
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-28694104100000X
IDLCSW-333321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker