Provider Demographics
NPI:1508039082
Name:BLECKER, CAROL K (MSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:K
Last Name:BLECKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:KESICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 WOOL ST.
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5549
Mailing Address - Country:US
Mailing Address - Phone:415-647-7716
Mailing Address - Fax:
Practice Address - Street 1:1 WOOL ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5549
Practice Address - Country:US
Practice Address - Phone:415-290-3251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA629021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical