Healthcare Provider Details

I. General information

NPI: 1295343580
Provider Name (Legal Business Name): KARA A KOWALSKI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 07/22/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 VOORHEESVILLE AVE
VOORHEESVILLE NY
12186-9724
US

IV. Provider business mailing address

6 VOORHEESVILLE AVE
VOORHEESVILLE NY
12186-9724
US

V. Phone/Fax

Practice location:
  • Phone: 518-209-2294
  • Fax:
Mailing address:
  • Phone: 518-209-2294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number006300-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: