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NPI Code Detail

MEDICARE: CAROLYN GEORGE LICSW

MEDICARE: CAROLYN GEORGE LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerDP00945995WV

General Provider Information

NPI Number : 1053950725
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN GEORGE LICSW
Provider Business Mailing Address
First Line : 4781 KEARNEYSVILLE PIKE
Second Line :
City : SHEPHERDSTOWN
State : WV
Zip : 25443-4666
Country : US
Telephone Number : 304-876-3500
Fax Number :
Provider Business Practice Location Address
First Line : 4781 KEARNEYSVILLE PIKE
Second Line :
City : SHEPHERDSTOWN
State : WV
Zip : 25443-4666
Country : US
Telephone Number : 304-876-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2019
Last Update Date : 05/27/2025

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