Provider Demographics
NPI:1336517663
Name:CARPENA, KAROL (MSW)
Entity Type:Individual
Prefix:
First Name:KAROL
Middle Name:
Last Name:CARPENA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KAROL
Other - Middle Name:PRISCILA
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:L3 CALLE GARDENIA BUZON 14
Mailing Address - Street 2:REPARTO BELLA VISTA
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-0014
Mailing Address - Country:US
Mailing Address - Phone:787-327-2245
Mailing Address - Fax:
Practice Address - Street 1:L3 CALLE GARDENIA BUZON 14
Practice Address - Street 2:REPARTO BELLA VISTA
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-0014
Practice Address - Country:US
Practice Address - Phone:787-327-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11250104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11250OtherMSW