Provider Demographics
NPI:1285159442
Name:AGUILAR, KARA ELISABETH (MA, LPCC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:ELISABETH
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 101ST AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-3201
Mailing Address - Country:US
Mailing Address - Phone:651-439-2059
Mailing Address - Fax:888-675-8262
Practice Address - Street 1:7362 UNIVERSITY AVE NE STE 307
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3150
Practice Address - Country:US
Practice Address - Phone:651-439-2059
Practice Address - Fax:888-675-8262
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01383101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1285159442Medicaid