MEDICARE: MS. CAROL ELIZABETH HOOKER LCSW, CAC

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	0904001781	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	187906	OTHER	VA	ANTHEM NUMBER
2	087656M	OTHER	VA	OPTIMA NUMBER

General Provider Information

NPI Number	:	1902989601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL ELIZABETH HOOKER LCSW, CAC

Provider Business Mailing Address
First Line	:	2936 LYNNHAVEN DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1524
Country	:	US
Telephone Number	:	757-496-9203
Fax Number	:

Provider Business Practice Location Address
First Line	:	3143 MAGIC HOLLOW BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-3077
Country	:	US
Telephone Number	:	757-385-4786
Fax Number	:

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/09/2007

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