Basic Information
Provider Information
NPI: 1235473851
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DROBNIS
FirstName: KARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW, LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 340 MAIN ST STE 383
Address2:  
City: WORCESTER
State: MA
PostalCode: 016081694
CountryCode: US
TelephoneNumber: 5087914976
FaxNumber:  
Practice Location
Address1: 340 MAIN ST STE 383
Address2:  
City: WORCESTER
State: MA
PostalCode: 016081694
CountryCode: US
TelephoneNumber: 5087914976
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/20/2012
LastUpdateDate: 11/20/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X216321MAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home