Provider Demographics
NPI:1891339347
Name:KRAWCZYK, CAROLE SUSAN (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:SUSAN
Last Name:KRAWCZYK
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 1:177 N SINGINGWOOD ST UNIT 14
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-5715
Mailing Address - Country:US
Mailing Address - Phone:714-538-9344
Mailing Address - Fax:
Practice Address - Street 1:177 N SINGINGWOOD ST UNIT 14
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-5715
Practice Address - Country:US
Practice Address - Phone:714-538-9344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW866931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical