Provider Demographics
NPI:1205667219
Name:URBANOVICH, CARLY
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:URBANOVICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:PIPERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18947-0250
Mailing Address - Country:US
Mailing Address - Phone:267-528-9037
Mailing Address - Fax:267-363-3220
Practice Address - Street 1:6926 OLD EASTON RD
Practice Address - Street 2:
Practice Address - City:PIPERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18947
Practice Address - Country:US
Practice Address - Phone:267-528-9037
Practice Address - Fax:267-363-3220
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker