Organization
CAROL HOOPER, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL HOOPER LCSW (OWNER/OPERATOR)
90450102846
Entity
Organization
Contact information
Practice address
9 EAST LN, ST AUGUSTINE, FL 32084-3209
(904) 501-0846
(904) 461-8368
Mailing address
9 EAST LN, ST AUGUSTINE, FL 32084-3209
(904) 501-0846
(904) 461-8368
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW5803
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070860700
—
FL
01
—
Z02UZ
BCBS
FL
Enumeration date
06/19/2011
Last updated
06/19/2011
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