Provider Demographics
NPI:1619411535
Name:KURTZ, CAROLYN
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:KURTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 GREENWICH ST
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-2810
Mailing Address - Country:US
Mailing Address - Phone:484-336-7208
Mailing Address - Fax:
Practice Address - Street 1:437 GREENWICH ST
Practice Address - Street 2:FLOOR 1
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-2810
Practice Address - Country:US
Practice Address - Phone:484-336-7208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133979104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker