MEDICARE: CAROL ANN WESTPHAL LCSW

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	0904005366	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225037880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL ANN WESTPHAL LCSW

Provider Business Mailing Address
First Line	:	6015 FOX POINT RD
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-8356
Country	:	US
Telephone Number	:	540-898-8844
Fax Number	:	540-898-9436

Provider Business Practice Location Address
First Line	:	3516 PLANK RD
Second Line	:	SUITE 5C
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-6861
Country	:	US
Telephone Number	:	540-786-3049
Fax Number	:	540-898-9436

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

Provider Enumeration Date	:	07/17/2005
Last Update Date	:	07/01/2015

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