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General NPI Number Information
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NPI Number | 1134229081
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Entity Type | Individual
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Provider Name | DOROTHY ELLEN CARSKADON LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 6010 W AMARILLO BLVD
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City | AMARILLO
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State | TX
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Zip | 79106-1990
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Country | US
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Telephone | 815-323-2516
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Fax |
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Provider Business Mailing Address
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Address Line | 344 COUNTY ROAD 309
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City | PANHANDLE
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State | TX
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Zip | 79068-7211
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Country | US
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Telephone | 815-961-9163
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Fax |
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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 | 149.008764
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 104727
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License Number State | TX
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