Provider Demographics
NPI:1760139166
Name:SOBOTKA, CAROLYN JANINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JANINE
Last Name:SOBOTKA
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 1:7506 QUAIL RUN DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3131
Mailing Address - Country:US
Mailing Address - Phone:210-765-9134
Mailing Address - Fax:
Practice Address - Street 1:7506 QUAIL RUN DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-3131
Practice Address - Country:US
Practice Address - Phone:210-765-9134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical