Provider Demographics
NPI:1063127587
Name:IRONSIDE, KARA (LAMFT)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:IRONSIDE
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 W YORKSHIRE DR APT 3130
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-3915
Mailing Address - Country:US
Mailing Address - Phone:928-242-8302
Mailing Address - Fax:
Practice Address - Street 1:9260 E RAINTREE DR STE 120
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7310
Practice Address - Country:US
Practice Address - Phone:480-382-8656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10868106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist