Provider Demographics
NPI:1588860043
Name:ASHENDORF, CAROLE SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:SUE
Last Name:ASHENDORF
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 1:11700 GAINSBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854
Mailing Address - Country:US
Mailing Address - Phone:281-216-0940
Mailing Address - Fax:832-565-8808
Practice Address - Street 1:1170 ST. JAMES PLACE #111
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056
Practice Address - Country:US
Practice Address - Phone:281-216-0940
Practice Address - Fax:832-565-8808
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27026171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator