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General NPI Number Information
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NPI Number | 1942796255
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Entity Type | Individual
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Provider Name | CARRIE LYNN CAMP LISW
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Gender | Female
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Dates
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Enumeration Date | 07/10/2018
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 544 E WOODRUFF AVE
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City | TOLEDO
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State | OH
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Zip | 43604-5342
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Country | US
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Telephone | 419-693-0631
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Fax | 419-936-7606
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Provider Business Mailing Address
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Address Line | 1425 STARR AVE
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City | TOLEDO
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State | OH
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Zip | 43605-2456
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Country | US
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Telephone | 419-693-0631
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Fax | 419-936-7606
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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 | S2105771
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2304604
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License Number State | OH
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