Provider Demographics
NPI:1578833257
Name:WHITE, KAROL L (LISW)
Entity Type:Individual
Prefix:
First Name:KAROL
Middle Name:L
Last Name:WHITE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4403 1ST AVE SE STE 503
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3257
Mailing Address - Country:US
Mailing Address - Phone:319-651-5955
Mailing Address - Fax:319-393-3458
Practice Address - Street 1:4403 1ST AVE SE STE 503
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3257
Practice Address - Country:US
Practice Address - Phone:319-651-5955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0071061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical