Healthcare Provider Details

I. General information

NPI: 1629490537
Provider Name (Legal Business Name): KARA KATHRYNE BAERTSCH LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARA KATHRYNE LASHER LMHC

II. Dates (important events)

Enumeration Date: 01/11/2014
Last Update Date: 01/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 N MONROE ST
BLOOMINGTON IN
47404-3321
US

IV. Provider business mailing address

803 N MONROE ST
BLOOMINGTON IN
47404-3321
US

V. Phone/Fax

Practice location:
  • Phone: 812-332-1262
  • Fax: 812-334-8464
Mailing address:
  • Phone: 812-332-1262
  • Fax: 812-334-8464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88000009A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: