South, Carolyn S

South, Carolyn S is an individual health care provider with primary practice located at 6558 Main Street Morgan Bldg., Ste 1 Office 3 And 3A, Gloucester VA 23061-4162. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. South, Carolyn S can be contacted via phone (804) 699-3238.

Contact Information

Primary practice address
6558 Main Street Morgan Bldg., Ste 1 Office 3 And 3A Gloucester VA 23061-4162
Phone: (804) 699-3238
Fax: (804) 699-3731
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0717000854 Virginia
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701001882 Virginia

Profile Details

NPI number 1700849148
LBN Legal business name South, Carolyn S
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Apr 27th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700849148 NPPES
Virginia MEDICAID 000000000000

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