Provider Demographics
NPI:1487005989
Name:SCHRIMPL, CARLY (LCSW)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:SCHRIMPL
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 1:25W661 INDIAN HILL WOODS
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1468
Mailing Address - Country:US
Mailing Address - Phone:630-803-3286
Mailing Address - Fax:
Practice Address - Street 1:25W661 INDIAN HILL WOODS
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1468
Practice Address - Country:US
Practice Address - Phone:630-803-3286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-26
Last Update Date:2016-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490184181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1041C0700XMedicaid