Provider Demographics
NPI:1497943427
Name:TOMS, CAROL LEE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:LEE
Last Name:TOMS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 3RD AVE W
Mailing Address - Street 2:#4
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-3339
Mailing Address - Country:US
Mailing Address - Phone:206-378-0843
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:MS325760
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-8759
Practice Address - Fax:206-744-4484
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000065681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical