Healthcare Provider Details

I. General information

NPI: 1134953615
Provider Name (Legal Business Name): KARA SCARBROUGH LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 PICKETT DR
ST AUGUSTINE FL
32084-6641
US

IV. Provider business mailing address

63 PICKETT DR
ST AUGUSTINE FL
32084-6641
US

V. Phone/Fax

Practice location:
  • Phone: 904-679-9252
  • Fax:
Mailing address:
  • Phone: 904-679-9252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW24678
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21897
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: