1003901224 NPI number — KAREN ANN CARRARO LCSW

Table of content: KAREN ANN CARRARO LCSW (NPI 1003901224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003901224 NPI number — KAREN ANN CARRARO LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARRARO
Provider First Name:
KAREN
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003901224
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3221 WEST OX ROAD
Provider Second Line Business Mailing Address:
SUNRISE I FAIRFAX AD5
Provider Business Mailing Address City Name:
HERNDON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20171
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-648-0887
Provider Business Mailing Address Fax Number:
703-758-6641

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3221 WEST OX ROAD
Provider Second Line Business Practice Location Address:
SUNRISE I FAIRFAX AD5
Provider Business Practice Location Address City Name:
HERNDON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20171
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-648-0887
Provider Business Practice Location Address Fax Number:
703-758-6641
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0904006306 . This is a "BOARD OF SOCIAL WORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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