Provider Demographics
NPI:1700555968
Name:YOUNGKRANTZ, CAROLINE WILCOX (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:WILCOX
Last Name:YOUNGKRANTZ
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:MS
Other - First Name:CAROLINE
Other - Middle Name:WILCOX
Other - Last Name:HENNESSY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LGSW
Mailing Address - Street 1:350 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BIRD ISLAND
Mailing Address - State:MN
Mailing Address - Zip Code:55310-1238
Mailing Address - Country:US
Mailing Address - Phone:708-227-6954
Mailing Address - Fax:
Practice Address - Street 1:1071 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3153
Practice Address - Country:US
Practice Address - Phone:708-227-6954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN292331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical