Provider Demographics
NPI:1821439662
Name:ESPEJO, KAROL (LCSW-C)
Entity Type:Individual
Prefix:
First Name:KAROL
Middle Name:
Last Name:ESPEJO
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WHITE OAK RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2327
Mailing Address - Country:US
Mailing Address - Phone:240-464-0068
Mailing Address - Fax:
Practice Address - Street 1:6O MARKET STREET
Practice Address - Street 2:213
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-5320
Practice Address - Country:US
Practice Address - Phone:240-242-7640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19018101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1821439662OtherSELF-EMPLOYED