=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093194227
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARRIE TODD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2015
-----------------------------------------------------
Last Update Date | 12/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 OLIN AVE
-----------------------------------------------------
City | GIRARD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16417-1527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-400-9741
-----------------------------------------------------
Fax | 814-400-9742
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 OLIN AVE
-----------------------------------------------------
City | GIRARD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16417-1527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-400-9741
-----------------------------------------------------
Fax | 814-400-9742
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CW025527
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LCSW-1399
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 13556788-3501
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------