Provider Demographics
NPI:1003188947
Name:SCHOLZ, CARRIE (MSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:SCHOLZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-2136
Mailing Address - Country:US
Mailing Address - Phone:315-446-9111
Mailing Address - Fax:315-446-1537
Practice Address - Street 1:4101 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-2136
Practice Address - Country:US
Practice Address - Phone:315-446-9111
Practice Address - Fax:315-446-1537
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060905-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker