Provider Demographics
NPI:1710438130
Name:CURRY, CAROLYN THOMAS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:THOMAS
Last Name:CURRY
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 1:902 PEEL CASTLE LN
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1455
Mailing Address - Country:US
Mailing Address - Phone:770-693-0201
Mailing Address - Fax:
Practice Address - Street 1:902 PEEL CASTLE LN
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1455
Practice Address - Country:US
Practice Address - Phone:770-693-0201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0019651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW001965OtherSTATE OF GEORGIA