Provider Demographics
NPI:1639137243
Name:CROLL, CAROLANNE DORINDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLANNE
Middle Name:DORINDA
Last Name:CROLL
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 1:1905 WHITE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-1483
Mailing Address - Country:US
Mailing Address - Phone:540-898-3824
Mailing Address - Fax:540-371-9038
Practice Address - Street 1:305 HANSON AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3126
Practice Address - Country:US
Practice Address - Phone:540-371-1124
Practice Address - Fax:540-371-9038
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040015301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical