Provider Demographics
NPI:1639726136
Name:GARGANO, CAREY (LISW-S)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:
Last Name:GARGANO
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5934 PENNYROYAL PL
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8560
Mailing Address - Country:US
Mailing Address - Phone:614-975-0599
Mailing Address - Fax:
Practice Address - Street 1:3350 CLEVELAND AVE STE 1964
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3677
Practice Address - Country:US
Practice Address - Phone:614-523-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1501238-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical