Provider Demographics
NPI:1861989907
Name:KRENZ, KARA LEE (MA, LMFTA, LMHCA)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:LEE
Last Name:KRENZ
Suffix:
Gender:F
Credentials:MA, LMFTA, LMHCA
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:LEE
Other - Last Name:WALKOWSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:921 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2316
Mailing Address - Country:US
Mailing Address - Phone:360-423-0203
Mailing Address - Fax:360-577-0269
Practice Address - Street 1:615 8TH ST
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550-3522
Practice Address - Country:US
Practice Address - Phone:360-532-4357
Practice Address - Fax:360-538-0124
Is Sole Proprietor?:No
Enumeration Date:2018-04-14
Last Update Date:2018-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60729804101YM0800X
WA60729808106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist