Provider Demographics
NPI:1891847323
Name:CARNER, NANCY C (MSW LISW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:C
Last Name:CARNER
Suffix:
Gender:F
Credentials:MSW LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:1440 W MAIN ST
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371
Mailing Address - Country:US
Mailing Address - Phone:937-667-4612
Mailing Address - Fax:937-667-6479
Practice Address - Street 1:1440 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371
Practice Address - Country:US
Practice Address - Phone:937-667-4612
Practice Address - Fax:937-667-6479
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI29241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical