Provider Demographics
NPI:1891812244
Name:CONTURO, CAROLYN DALLAS (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:DALLAS
Last Name:CONTURO
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5605 BARBARY COAST DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-9708
Mailing Address - Country:US
Mailing Address - Phone:252-514-4770
Mailing Address - Fax:252-514-4773
Practice Address - Street 1:2842 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2839
Practice Address - Country:US
Practice Address - Phone:252-514-4770
Practice Address - Fax:252-514-4773
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0030521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical