Provider Demographics
NPI:1114736980
Name:LONG, KARA K (SWT)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:K
Last Name:LONG
Suffix:
Gender:F
Credentials:SWT
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:NOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-2709
Mailing Address - Country:US
Mailing Address - Phone:937-902-2183
Mailing Address - Fax:888-585-0916
Practice Address - Street 1:121 E NORTH ST
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-2709
Practice Address - Country:US
Practice Address - Phone:937-902-2183
Practice Address - Fax:888-585-0916
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2403359-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker