Basic Information
Provider Information
NPI: 1003150582
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: CARA
MiddleName: L
NamePrefix: MS.
NameSuffix:  
Credential: LSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 769
Address2:  
City: JASPER
State: IN
PostalCode: 475470769
CountryCode: US
TelephoneNumber: 8124823020
FaxNumber: 8124826409
Practice Location
Address1: 488 W HOSPITAL RD
Address2:  
City: PAOLI
State: IN
PostalCode: 474548807
CountryCode: US
TelephoneNumber: 8127234301
FaxNumber: 8127234306
Other Information
ProviderEnumerationDate: 11/21/2012
LastUpdateDate: 11/21/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X33006459AINY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


Home