Provider Demographics
NPI:1124530837
Name:WESLEY, CAROL JOYCE (MSW LCSW CSAC)
Entity type:Individual
Prefix:MISS
First Name:CAROL
Middle Name:JOYCE
Last Name:WESLEY
Suffix:
Gender:F
Credentials:MSW LCSW CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5354 SIR BARTON DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-4154
Mailing Address - Country:US
Mailing Address - Phone:757-285-5954
Mailing Address - Fax:
Practice Address - Street 1:930 REDGATE AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1518
Practice Address - Country:US
Practice Address - Phone:757-626-3733
Practice Address - Fax:757-626-3331
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040089621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical