Provider Demographics
NPI:1083959787
Name:AUSTIN, CAROLYN GEE (LGSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:GEE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 NEIGHBOR LN
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1049
Mailing Address - Country:US
Mailing Address - Phone:301-322-3996
Mailing Address - Fax:301-322-5547
Practice Address - Street 1:3610 NEIGHBOR LN
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1049
Practice Address - Country:US
Practice Address - Phone:301-322-3996
Practice Address - Fax:301-322-5547
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG08695104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker