Provider Demographics
NPI:1720489875
Name:GAY, KARA JILL (LISW-S;LCSW)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:JILL
Last Name:GAY
Suffix:
Gender:F
Credentials:LISW-S;LCSW
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:GAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW-S; LCSW
Mailing Address - Street 1:801 WEST 8TH STREET
Mailing Address - Street 2:BUILDING A, SUITE 200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45203
Mailing Address - Country:US
Mailing Address - Phone:513-338-0552
Mailing Address - Fax:513-338-0550
Practice Address - Street 1:801 W 8TH ST
Practice Address - Street 2:BUILDING A, SUITE 200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45203-1601
Practice Address - Country:US
Practice Address - Phone:513-338-0552
Practice Address - Fax:513-338-0550
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17611041C0700X
OHI.00095491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical