Provider Demographics
NPI:1598784894
Name:PIERCE, CAROLYN MORRIS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:MORRIS
Last Name:PIERCE
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 1:5104 N BAY HILL CT
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2679
Mailing Address - Country:US
Mailing Address - Phone:757-638-7383
Mailing Address - Fax:757-638-3373
Practice Address - Street 1:5104 N BAY HILL CT
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2679
Practice Address - Country:US
Practice Address - Phone:757-638-7383
Practice Address - Fax:757-638-3373
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040051631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA246323OtherANTHEM