=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982660353
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAROLYN WHITE HUNTER MSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2006
-----------------------------------------------------
Last Update Date | 11/24/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6540 WAY AVE BATTLEMIND CENTER BLDG. 2822
-----------------------------------------------------
City | FORT BENNING
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31905-3799
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-626-2617
-----------------------------------------------------
Fax | 170-662-6269
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1305 WHITE RD
-----------------------------------------------------
City | OPELIKA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36801-3431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-626-2768
-----------------------------------------------------
Fax | 170-662-6269
-----------------------------------------------------
=====================================================
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 | 0959C
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------