Provider Demographics
NPI:1972891802
Name:SMILEY, CAREN SAGE (LCSW)
Entity Type:Individual
Prefix:
First Name:CAREN
Middle Name:SAGE
Last Name:SMILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SAGE
Other - Middle Name:
Other - Last Name:SMILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:340 SOQUEL AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2328
Mailing Address - Country:US
Mailing Address - Phone:831-234-6043
Mailing Address - Fax:
Practice Address - Street 1:340 SOQUEL AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2328
Practice Address - Country:US
Practice Address - Phone:831-234-6043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA269861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical