Provider Demographics
NPI:1912048471
Name:KYRIMES, CAROL (LSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:KYRIMES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4323
Mailing Address - Country:US
Mailing Address - Phone:724-222-0741
Mailing Address - Fax:724-225-6811
Practice Address - Street 1:279 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4323
Practice Address - Country:US
Practice Address - Phone:724-222-0741
Practice Address - Fax:724-225-6811
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW000858E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASW000858EOtherLICENSED SOCIAL WORKER