Provider Demographics
NPI:1740904549
Name:KEHN, CAROLYN MORGAN (LCSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MORGAN
Last Name:KEHN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BUILDING 475
Mailing Address - Street 2:
Mailing Address - City:GRAFENWOEHR
Mailing Address - State:BAVARIA
Mailing Address - Zip Code:92655
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 475
Practice Address - Street 2:
Practice Address - City:GRAFENWOEHR
Practice Address - State:BAVARIA
Practice Address - Zip Code:92655
Practice Address - Country:DE
Practice Address - Phone:637-194-6430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.108495104100000X
IL149.0271691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL150.108495OtherLICENSED SOCIAL WORKER
IL149.027169OtherLICENSED CLINICAL SOCIAL WORKER