Provider Demographics
NPI:1538221601
Name:TORTORICI, CAROLYN JO (LICSW, LCSW-C, PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:JO
Last Name:TORTORICI
Suffix:
Gender:F
Credentials:LICSW, LCSW-C, PHD
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:JO
Other - Last Name:GRAME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:903 9TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3713
Mailing Address - Country:US
Mailing Address - Phone:202-399-3975
Mailing Address - Fax:202-737-3557
Practice Address - Street 1:1012 14TH ST., NW
Practice Address - Street 2:SUITE 810
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3406
Practice Address - Country:US
Practice Address - Phone:202-654-0855
Practice Address - Fax:202-737-3557
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC30008141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical