Provider Demographics
NPI:1053950725
Name:GEORGE, CAROLYN (LICSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4781 KEARNEYSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25443-4666
Mailing Address - Country:US
Mailing Address - Phone:304-876-3500
Mailing Address - Fax:
Practice Address - Street 1:4781 KEARNEYSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:SHEPHERDSTOWN
Practice Address - State:WV
Practice Address - Zip Code:25443-4666
Practice Address - Country:US
Practice Address - Phone:304-876-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009459951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical