Basic Information
| Provider Information | |||||||||
| NPI: | 1497290175 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAIN | ||||||||
| FirstName: | KARAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 402 S SILVER SPRINGS RD | ||||||||
| Address2: | |||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637037536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733341100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 309-311 GARRETT | ||||||||
| Address2: | |||||||||
| City: | FREDERICKTOWN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 636451084 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737834104 | ||||||||
| FaxNumber: | 5737834572 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2017 | ||||||||
| LastUpdateDate: | 09/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 2016040354 | MO | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.