Provider Demographics
NPI:1164287405
Name:SHULMAN, CAROLYN BETH (MSW, ACSW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:BETH
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4724 25TH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3525
Mailing Address - Country:US
Mailing Address - Phone:415-235-6984
Mailing Address - Fax:
Practice Address - Street 1:600 5TH AVE
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3348
Practice Address - Country:US
Practice Address - Phone:415-726-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119763101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor