1467588962 NPI number — MRS. KARA ELIZABETH NEWINGHAM LPC-S

Table of content: MRS. KARA ELIZABETH NEWINGHAM LPC-S (NPI 1467588962)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467588962 NPI number — MRS. KARA ELIZABETH NEWINGHAM LPC-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWINGHAM
Provider First Name:
KARA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC-S
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GAROFAS
Provider Other First Name:
KARA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467588962
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2706 HODGES ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE CHARLES
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70601-7366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-491-1740
Provider Business Mailing Address Fax Number:
337-491-1741

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2706 HODGES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE CHARLES
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70601-7366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-491-1740
Provider Business Practice Location Address Fax Number:
337-491-1741
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 4072 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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