Provider Demographics
NPI:1144650557
Name:JOBSON, CAROL (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:JOBSON
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25315 148TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2829
Mailing Address - Country:US
Mailing Address - Phone:516-623-7741
Mailing Address - Fax:516-623-7775
Practice Address - Street 1:380 NASSAU RD
Practice Address - Street 2:LL
Practice Address - City:ROOSEVELT
Practice Address - State:NY
Practice Address - Zip Code:11575-1343
Practice Address - Country:US
Practice Address - Phone:516-623-7741
Practice Address - Fax:516-623-7775
Is Sole Proprietor?:No
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR038629-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical