Healthcare Provider Details

I. General information

NPI: 1093373649
Provider Name (Legal Business Name): KARA RICHARDS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W SAGINAW HWY STE B
GRAND LEDGE MI
48837-1800
US

IV. Provider business mailing address

705 N FRANCIS AVE
LANSING MI
48912-4309
US

V. Phone/Fax

Practice location:
  • Phone: 517-338-3090
  • Fax: 517-338-3090
Mailing address:
  • Phone: 517-449-3680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401020317
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: