Provider Demographics
NPI:1841488624
Name:NOWAKOWSKI-CARLSON, MONICA Z (LCSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:Z
Last Name:NOWAKOWSKI-CARLSON
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 1:5435 COLLEGE AVE
Mailing Address - Street 2:103
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1598
Mailing Address - Country:US
Mailing Address - Phone:510-234-4100
Mailing Address - Fax:
Practice Address - Street 1:5435 COLLEGE AVE
Practice Address - Street 2:103
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1598
Practice Address - Country:US
Practice Address - Phone:510-234-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 134191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical