Doctor Name: | CAROL PRUITT |
NPI Number: | 1205958246 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 23001 |
Business Practice Address: | 4113 Scotts Valley Dr Ste 104 Scotts Valley, CA - 950664547 |
Business Phone Number: | 8314292288 |
Business Fax Number: | 8314619700 |
Mailing Address: | Po Box 4161, SANTA CRUZ |
State: | CA |
Postal Code: | 950634161 |
Phone Number: | 8314292288 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 07/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 23001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |