Provider Demographics
NPI:1992713150
Name:KUGEL, CARA LISA (LPC)
Entity type:Individual
Prefix:MRS
First Name:CARA
Middle Name:LISA
Last Name:KUGEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CARA
Other - Middle Name:LISA
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1311 CHISHOLM TRAIL
Mailing Address - Street 2:#301
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681
Mailing Address - Country:US
Mailing Address - Phone:512-923-7397
Mailing Address - Fax:512-248-9833
Practice Address - Street 1:1311 CHISHOLM TRAIL
Practice Address - Street 2:#301
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681
Practice Address - Country:US
Practice Address - Phone:512-923-7397
Practice Address - Fax:512-248-9833
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14782101Y00000X
TXTXLPC#14782101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor