Provider Demographics
NPI:1134215536
Name:PAPE, CAROLYN SUE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:SUE
Last Name:PAPE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:SUE
Other - Last Name:GRACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:211 BAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8713
Mailing Address - Country:US
Mailing Address - Phone:910-319-3196
Mailing Address - Fax:910-319-3106
Practice Address - Street 1:7741 MARKET ST
Practice Address - Street 2:SUITE H
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-8806
Practice Address - Country:US
Practice Address - Phone:910-343-8424
Practice Address - Fax:910-686-7770
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0054061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical