Provider Demographics
NPI:1073126462
Name:EASTON, CAROL JOY (LCSW, CADC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JOY
Last Name:EASTON
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:JOY
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LBSW, CADC
Mailing Address - Street 1:PINES BEHAVIORAL HEALTH
Mailing Address - Street 2:200 VISTA DR.
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1776
Mailing Address - Country:US
Mailing Address - Phone:517-278-2129
Mailing Address - Fax:517-279-8172
Practice Address - Street 1:PINES BEHAVIORAL HEALTH
Practice Address - Street 2:200 VISTA DR.
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1776
Practice Address - Country:US
Practice Address - Phone:517-278-2129
Practice Address - Fax:517-279-8172
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802084008171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator