Provider Demographics
NPI:1154382000
Name:GIANELO, CAROL L (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:L
Last Name:GIANELO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:LORRAINE
Other - Last Name:COULTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 SOUTH SKYCREST LN
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1604
Mailing Address - Country:US
Mailing Address - Phone:801-205-4890
Mailing Address - Fax:801-521-0311
Practice Address - Street 1:1355 S 1100 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-2432
Practice Address - Country:US
Practice Address - Phone:801-205-4890
Practice Address - Fax:801-521-0311
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT370522-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical