Healthcare Provider Details

I. General information

NPI: 1679764922
Provider Name (Legal Business Name): CAROL JOAN SINGER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2484 SHATTUCK AVE
BERKELEY CA
94704-2076
US

IV. Provider business mailing address

1727 MLK JR WAY STE 109
OAKLAND CA
94612-1358
US

V. Phone/Fax

Practice location:
  • Phone: 510-704-7475
  • Fax: 510-704-7494
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS11742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: