Provider Demographics
NPI:1114551652
Name:GREENSPAN, CAROLYN ELIZABETH (LICSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ELIZABETH
Last Name:GREENSPAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1853 INGLESIDE TER NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-1009
Mailing Address - Country:US
Mailing Address - Phone:502-350-7339
Mailing Address - Fax:
Practice Address - Street 1:3101 13TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2407
Practice Address - Country:US
Practice Address - Phone:202-696-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000025171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical