Individual
CAROLYN PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
505 5TH ST STE 520, SIOUX CITY, IA 51101-1506
(712) 224-2892
(712) 224-2891
Mailing address
505 5TH ST STE 520, SIOUX CITY, IA 51101-1506
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01733
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013938
—
IA
05
—
35117800000106704150
—
IA
01
—
38080
BCBS PROVIDER #
IA
Enumeration date
01/05/2007
Last updated
07/09/2007
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