Healthcare Provider Details

I. General information

NPI: 1689055972
Provider Name (Legal Business Name): CAROL ANNE ALLEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 W OXFORD LOOP STE 146
OXFORD MS
38655-5575
US

IV. Provider business mailing address

2690 W OXFORD LOOP STE 146
OXFORD MS
38655-5575
US

V. Phone/Fax

Practice location:
  • Phone: 662-638-3707
  • Fax: 662-495-7178
Mailing address:
  • Phone: 662-638-3707
  • Fax: 662-495-7178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC5361
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: