Provider Demographics
NPI:1285019836
Name:WNUK, CAROLYN ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANN
Last Name:WNUK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 KENDRICK ST
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1544
Mailing Address - Country:US
Mailing Address - Phone:888-658-1145
Mailing Address - Fax:774-237-0221
Practice Address - Street 1:19 KENDRICK ST
Practice Address - Street 2:
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-1544
Practice Address - Country:US
Practice Address - Phone:888-658-1145
Practice Address - Fax:774-237-0221
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1185661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical