Provider Demographics
NPI:1386049468
Name:LOCKE, CAROLINE (LCSW)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:LOCKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13502 WAKEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4976
Mailing Address - Country:US
Mailing Address - Phone:850-287-9183
Mailing Address - Fax:
Practice Address - Street 1:756 PURPLE SAGE RD
Practice Address - Street 2:
Practice Address - City:BANDERA
Practice Address - State:TX
Practice Address - Zip Code:78003-3981
Practice Address - Country:US
Practice Address - Phone:830-225-1622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 120991041C0700X
TX1074191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical