Provider Demographics
NPI:1265086458
Name:HOSKINS, CAROLYN R (LSW, LCDC III)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:R
Last Name:HOSKINS
Suffix:
Gender:F
Credentials:LSW, LCDC III
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:R
Other - Last Name:NEECE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW, LCDC III
Mailing Address - Street 1:4977 NORTHCUTT PL
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-3839
Mailing Address - Country:US
Mailing Address - Phone:937-387-6395
Mailing Address - Fax:
Practice Address - Street 1:4977 NORTHCUTT PL
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-3839
Practice Address - Country:US
Practice Address - Phone:937-387-6395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH162182101YA0400X
OHS.1600536104100000X
OHCDCA.130141101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)