Provider Demographics
NPI:1225123102
Name:WINETROUB, CAROL ANN (LISW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:WINETROUB
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 HIGHWAY 6 WEST
Mailing Address - Street 2:002B/SPEC
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-2208
Mailing Address - Country:US
Mailing Address - Phone:319-338-0581
Mailing Address - Fax:319-339-7115
Practice Address - Street 1:601 HIGHWAY 6 WEST
Practice Address - Street 2:002B/SPEC
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-2208
Practice Address - Country:US
Practice Address - Phone:319-338-0581
Practice Address - Fax:319-339-7115
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA026211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical