Provider Demographics
NPI:1992026900
Name:OLDERMAN, CAROLE LAURIE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:LAURIE
Last Name:OLDERMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 STORRS ROAD
Mailing Address - Street 2:189 STORRS ROAD NATCHAUG HOSPITAL,
Mailing Address - City:MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06250
Mailing Address - Country:US
Mailing Address - Phone:860-456-1311
Mailing Address - Fax:
Practice Address - Street 1:189 STORRS ROAD, 06250
Practice Address - Street 2:NATCHAUG HOSPITAL,
Practice Address - City:MANSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06250
Practice Address - Country:US
Practice Address - Phone:860-456-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker