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General NPI Number Information
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NPI Number | 1093794570
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Entity Type | Individual
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Provider Name | CAROL E KOLEK LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19 COUNTY RD
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City | MATTAPOISETTE
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State | MA
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Zip | 02739
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Country | US
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Telephone | 508-758-3754
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Fax | 508-758-3755
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Provider Business Mailing Address
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Address Line | PO BOX 71
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City | MATTAPOISETT
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State | MA
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Zip | 02739-0071
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Country | US
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Telephone | 508-758-3757
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Fax | 508-758-3755
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 102069
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License Number State | MA
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