Provider Demographics
NPI:1619172194
Name:CAROLYN A. TRASKO LLC
Entity Type:Organization
Organization Name:CAROLYN A. TRASKO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TRASKO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-334-1477
Mailing Address - Street 1:32350 PRESERVE DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-5977
Mailing Address - Country:US
Mailing Address - Phone:302-827-3356
Mailing Address - Fax:
Practice Address - Street 1:28312 LEWES GEORGETOWN HWY
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:DE
Practice Address - Zip Code:19968-3115
Practice Address - Country:US
Practice Address - Phone:302-827-3356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CT004350251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT140004350CT07OtherANTHEM
CT191022OtherMHN
CT2033944OtherCIGNA
CTP3050702OtherOXFORD
CT004254710Medicaid
CT706412000OtherMAGELLAN
CT336119OtherVALUE OPTIONS
CT0007721113OtherAETNA