Provider Demographics
NPI:1932358777
Name:HENRY, CARA R (LCSW)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:R
Last Name:HENRY
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 1:200 PROFESSIONAL PARK DR SE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-6679
Mailing Address - Country:US
Mailing Address - Phone:540-951-4800
Mailing Address - Fax:
Practice Address - Street 1:200 PROFESSIONAL PARK DR SE
Practice Address - Street 2:SUITE 4
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-6679
Practice Address - Country:US
Practice Address - Phone:540-951-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040082831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical