MEDICARE: MS. CAROL LYNN PASEWARK M.ED., LPC

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	101Y00000X	Counselor	2004000710	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1437294816	OTHER	MO	CEDAR RIDGE NPI
2	1649269622	OTHER	MO	GROUP BILLING NPI

General Provider Information

NPI Number	:	1982601803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL LYNN PASEWARK M.ED., LPC

Provider Business Mailing Address
First Line	:	650 JOEL DR
Second Line	:
City	:	FORT CAMPBELL
State	:	KY
Zip	:	42223-5318
Country	:	US
Telephone Number	:	270-956-3847
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 JOEL DR
Second Line	:
City	:	FORT CAMPBELL
State	:	KY
Zip	:	42223-5318
Country	:	US
Telephone Number	:	270-412-3112
Fax Number	:

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/22/2020

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