Provider Demographics
NPI:1194815217
Name:ABBRUZZESE, CAROLYN ANN (LISW-S, CDCA)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANN
Last Name:ABBRUZZESE
Suffix:
Gender:F
Credentials:LISW-S, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 ROSWELL PL
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8667
Mailing Address - Country:US
Mailing Address - Phone:740-881-1168
Mailing Address - Fax:740-881-1168
Practice Address - Street 1:161 S LIBERTY ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7619
Practice Address - Country:US
Practice Address - Phone:614-361-5643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00084201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical