Provider Demographics
NPI:1093469223
Name:HALLINAN, CAROLYN PATRICIA
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:PATRICIA
Last Name:HALLINAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 UNION ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-8731
Mailing Address - Country:US
Mailing Address - Phone:863-370-2728
Mailing Address - Fax:
Practice Address - Street 1:400 UNION ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-8731
Practice Address - Country:US
Practice Address - Phone:863-370-2728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW103301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical