Individual
CAROL HOOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2120 US 1 S, ST AUGUSTINE, FL 32086-4205
(904) 501-0846
(904) 217-7257
Mailing address
2120 US 1 S, ST AUGUSTINE, FL 32086-4205
(904) 209-6009
(904) 209-6002
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW5803
FL
106H00000X
Marriage & Family Therapist
MT2052
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070860700
—
FL
01
—
Z029V
BCBS
FL
Enumeration date
10/18/2005
Last updated
08/25/2019
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