Provider Demographics
NPI:1194062869
Name:CAFFREY, KARA (MED)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:CAFFREY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 METHUEN ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1700
Mailing Address - Country:US
Mailing Address - Phone:978-808-5852
Mailing Address - Fax:
Practice Address - Street 1:12 METHUEN ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1700
Practice Address - Country:US
Practice Address - Phone:978-808-5852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1916751101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool