MEDICARE: CAROL WHITESCARVER 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	34004268A	IN
2	1041C0700X	Clinical Social Worker	LCSW-18360	AZ

General Provider Information

NPI Number	:	1467572818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL WHITESCARVER LCSW

Provider Business Mailing Address
First Line	:	2118 N CHRYSLER DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-2906
Country	:	US
Telephone Number	:	505-274-2461
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 E MISSOURI AVE STE 340
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-2753
Country	:	US
Telephone Number	:	602-932-3336
Fax Number	:

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	04/19/2023

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