Provider Demographics
NPI:1740649797
Name:GRACE, KARA (MS, LPC, BCBA)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:GRACE
Suffix:
Gender:F
Credentials:MS, LPC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 N PERKINS RD STE 3
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-1701
Mailing Address - Country:US
Mailing Address - Phone:405-714-7160
Mailing Address - Fax:405-533-3333
Practice Address - Street 1:4806 N PERKINS RD STE 3
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-1701
Practice Address - Country:US
Practice Address - Phone:405-714-7160
Practice Address - Fax:405-533-3333
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7740101YM0800X
171M00000X
TX96289101YM0800X
OK1-20-43677103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst