Provider Demographics
NPI:1518261593
Name:OLZINSKI, CAROL AUGUSTA (LSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:AUGUSTA
Last Name:OLZINSKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013
Mailing Address - Country:US
Mailing Address - Phone:610-588-9109
Mailing Address - Fax:610-588-5016
Practice Address - Street 1:51 MARKET STREET
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013
Practice Address - Country:US
Practice Address - Phone:610-588-9109
Practice Address - Fax:610-588-5016
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128326104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker