Provider Demographics
NPI:1861761744
Name:LAFACHE, KARA S (LMSW)
Entity type:Individual
Prefix:MS
First Name:KARA
Middle Name:S
Last Name:LAFACHE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-3700
Mailing Address - Country:US
Mailing Address - Phone:315-534-5418
Mailing Address - Fax:
Practice Address - Street 1:1115 MOHAWK ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-3700
Practice Address - Country:US
Practice Address - Phone:315-534-5418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72 0755471041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool