Provider Demographics
NPI:1316035173
Name:KERN, CAROLYN G (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:G
Last Name:KERN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:36729 BI STATE BLVD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:DE
Mailing Address - Zip Code:19940-3427
Mailing Address - Country:US
Mailing Address - Phone:302-260-2159
Mailing Address - Fax:302-846-3028
Practice Address - Street 1:9391 MULLIGAN WAY
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:MD
Practice Address - Zip Code:21875-2376
Practice Address - Country:US
Practice Address - Phone:302-260-2159
Practice Address - Fax:302-846-3028
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16591104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker