Provider Demographics
NPI:1639458243
Name:DEPUTY, CAROL (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:DEPUTY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INNOVATION WAY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5442
Mailing Address - Country:US
Mailing Address - Phone:302-294-8550
Mailing Address - Fax:302-266-8697
Practice Address - Street 1:1 INNOVATION WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5442
Practice Address - Country:US
Practice Address - Phone:302-294-8550
Practice Address - Fax:302-266-8697
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical