Provider Demographics
NPI:1629056858
Name:ORTON, CAROL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:ORTON
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:PO BOX 1885
Mailing Address - Street 2:
Mailing Address - City:WILLITS
Mailing Address - State:CA
Mailing Address - Zip Code:95490-1885
Mailing Address - Country:US
Mailing Address - Phone:707-459-3124
Mailing Address - Fax:
Practice Address - Street 1:239 E VALLEY ST
Practice Address - Street 2:
Practice Address - City:WILLITS
Practice Address - State:CA
Practice Address - Zip Code:95490-3623
Practice Address - Country:US
Practice Address - Phone:707-459-3124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 173311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS17331OtherCA LICENSE #
CALCS17331OtherCA LICENSE #