Provider Demographics
NPI:1942677034
Name:NORTH, CAROLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:NORTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1515 W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-3307
Mailing Address - Country:US
Mailing Address - Phone:561-395-8920
Mailing Address - Fax:561-338-9127
Practice Address - Street 1:7860 GLADES RD
Practice Address - Street 2:SUITE 225
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4176
Practice Address - Country:US
Practice Address - Phone:561-361-0500
Practice Address - Fax:561-479-0384
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW64221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical