Kara Rose Ickes

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P020244 Issued in ND

Practice address

402 Harris Ave
Raeford, NC 28376-3112

Phone

(910) 875-5590

Fax

(910) 875-5008

NPI assigned

Feb 23, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Greater Vision Counseling & Consulting Agency PLLC

  • Clinical Social Worker
  • Raeford, NC
  • NPI 1336661826
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1255197604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 HARRIS AVE",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283763112",
            "telephone_number": "910-875-5590",
            "fax_number": "910-875-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 HARRIS AVE",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283763112",
            "telephone_number": "910-875-5590",
            "fax_number": "910-875-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICKES",
        "first_name": "KARA",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "P020244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda K. Hughes, M.D.
• Kourtney Monshae Humes
• Erin M Hunt Gist
• Patrick Scott Hurley, P.A
• Tekaria Hurley
• Independence Counseling and Consulting Services, PLLC
• Charles Thomas Inman, OD
• Innovative Therapeutic Services
• Integrated Mental Health Services Agency Inc
• Integrity-Open Arms, LLC

• Clinical Social Worker in Raeford, NC
• Providers in Raeford, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.