Provider Demographics
NPI:1407294283
Name:MOHWINKLE, CAROLYN M (MSW,LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:M
Last Name:MOHWINKLE
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 RARITAN AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2752
Mailing Address - Country:US
Mailing Address - Phone:732-956-6107
Mailing Address - Fax:732-985-8060
Practice Address - Street 1:320 RARITAN AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2752
Practice Address - Country:US
Practice Address - Phone:732-956-6107
Practice Address - Fax:732-985-8060
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055360001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical