Provider Demographics
NPI:1699920645
Name:BUMGARNER, KARA LYNN (MHC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:LYNN
Last Name:BUMGARNER
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 S TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-9216
Mailing Address - Country:US
Mailing Address - Phone:941-780-1148
Mailing Address - Fax:941-706-1187
Practice Address - Street 1:654 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-9216
Practice Address - Country:US
Practice Address - Phone:941-780-1148
Practice Address - Fax:941-706-1187
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10745101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health