Provider Demographics
NPI:1366449738
Name:ELLINGER, CAROL E (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:E
Last Name:ELLINGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-0002
Mailing Address - Country:US
Mailing Address - Phone:540-664-6968
Mailing Address - Fax:
Practice Address - Street 1:27 S ROYAL AVE
Practice Address - Street 2:SUITE 370
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3281
Practice Address - Country:US
Practice Address - Phone:540-664-6968
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical