Provider Demographics
NPI:1144631805
Name:SMITH, CAROLYN WHITLOCK (LCSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:WHITLOCK
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-0021
Mailing Address - Country:US
Mailing Address - Phone:828-275-7981
Mailing Address - Fax:
Practice Address - Street 1:32 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-0316
Practice Address - Country:US
Practice Address - Phone:828-350-1177
Practice Address - Fax:828-350-1188
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0103161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical