Provider Demographics
NPI:1700895588
Name:MARKS, CAROLE (MSW,CSW,CCFC)
Entity Type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:
Last Name:MARKS
Suffix:
Gender:F
Credentials:MSW,CSW,CCFC
Other - Prefix:MRS
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:CASTRONOVO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:1955 US HIGHWAY 1 SOUTH
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5786
Mailing Address - Country:US
Mailing Address - Phone:904-209-6061
Mailing Address - Fax:904-209-6002
Practice Address - Street 1:1955 US HIGHWAY 1 S
Practice Address - Street 2:SUITE C-2
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-3708
Practice Address - Country:US
Practice Address - Phone:904-209-6061
Practice Address - Fax:904-209-6002
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical