MEDICARE: CAROLYN CONNERS AKHTAR 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
1	1041C0700X	Clinical Social Worker	LW61685196	WA

General Provider Information

NPI Number	:	1457953192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN CONNERS AKHTAR LICSW

Provider Business Mailing Address
First Line	:	575 LUHN AVE FL 2
Second Line	:
City	:	LANGLEY
State	:	WA
Zip	:	98260-8655
Country	:	US
Telephone Number	:	646-320-0900
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 648
Second Line	:
City	:	CLINTON
State	:	WA
Zip	:	98236-0648
Country	:	US
Telephone Number	:	425-215-6320
Fax Number	:	425-215-6320

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

Provider Enumeration Date	:	11/09/2020
Last Update Date	:	02/02/2026

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Directions to “ CAROLYN CONNERS AKHTAR LICSW” Practice Location

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