Organization
CAPTIOL CITY FAMILY EDUCATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN ANN THORPE LCSW (CLINICAL MANAGER)
(219) 427-0193
Entity
Organization
Contact information
Practice address
6049 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 427-0193
Mailing address
6049 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 427-0193
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006764A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942561162
—
IN
Enumeration date
10/05/2015
Last updated
10/05/2015
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