Provider Demographics
NPI:1649485442
Name:GUADAGNOLO, CAROLYN MAY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:MAY
Last Name:GUADAGNOLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3240 SHASTA WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-3432
Mailing Address - Country:US
Mailing Address - Phone:916-734-8299
Mailing Address - Fax:916-734-5811
Practice Address - Street 1:4501 X ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2229
Practice Address - Country:US
Practice Address - Phone:916-734-8299
Practice Address - Fax:916-734-5811
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS115901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical