Provider Demographics
NPI:1043362569
Name:KNOWLES, CAROLYN R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:R
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 WEST SECOND STREET
Mailing Address - Street 2:P.O. DRAWER 1403
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70527-1403
Mailing Address - Country:US
Mailing Address - Phone:337-788-7511
Mailing Address - Fax:337-788-7588
Practice Address - Street 1:1822 WEST SECOND ST
Practice Address - Street 2:P.O. DRAWER 1403
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70527-1403
Practice Address - Country:US
Practice Address - Phone:337-788-7511
Practice Address - Fax:337-788-7588
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical