MEDICARE: CAROLYN ANN ABBRUZZESE LISW-S, CDCA

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
1	1041C0700X	Clinical Social Worker	I-0008420	OH

General Provider Information

NPI Number	:	1194815217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN ANN ABBRUZZESE LISW-S, CDCA

Provider Business Mailing Address
First Line	:	138 ROSWELL PL
Second Line	:
City	:	POWELL
State	:	OH
Zip	:	43065-8667
Country	:	US
Telephone Number	:	740-881-1168
Fax Number	:	740-881-1168

Provider Business Practice Location Address
First Line	:	161 S LIBERTY ST
Second Line	:
City	:	POWELL
State	:	OH
Zip	:	43065-7619
Country	:	US
Telephone Number	:	614-361-5643
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	10/09/2013

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