Organization
LENNY CARL LCSW, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LENORA JEAN CARL LCSW (PRESIDENT)
(574) 262-9319
Entity
Organization
Contact information
Practice address
1626 N BAY DR, ELKHART, IN 46514-4270
(574) 262-8116
Mailing address
2801 E BRISTOL ST, ELKHART, IN 46514-4386
(574) 262-9319
(574) 262-2269
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003787A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200251470A
—
IN
Enumeration date
11/22/2010
Last updated
11/22/2010
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