MEDICARE: CARRIE FRANCES FOLEY MSW, LCSW, ACSW

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	34004153	IN
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	87001294A	IN

General Provider Information

NPI Number	:	1912980657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE FRANCES FOLEY MSW, LCSW, ACSW

Provider Business Mailing Address
First Line	:	645 S ROGERS ST
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47403-2353
Country	:	US
Telephone Number	:	812-339-1691
Fax Number	:	812-337-2438

Provider Business Practice Location Address
First Line	:	91 W MOUND ST
Second Line	:
City	:	NASHVILLE
State	:	IN
Zip	:	47448-7049
Country	:	US
Telephone Number	:	812-988-2258
Fax Number	:	812-337-2438

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

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	08/12/2015

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