Healthcare Provider Details

I. General information

NPI: 1013214873
Provider Name (Legal Business Name): KARA CYR CADC, MHRT-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 MAIN ST
LIMESTONE ME
04750-6607
US

IV. Provider business mailing address

382 MAIN ST
LIMESTONE ME
04750-6607
US

V. Phone/Fax

Practice location:
  • Phone: 207-325-4727
  • Fax: 207-325-4308
Mailing address:
  • Phone: 207-325-4727
  • Fax: 207-325-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC5000
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: