Provider Demographics
NPI:1487791901
Name:HARRINGTON, CAROL VICTORIA (MSW, ACSW,LMSW)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:VICTORIA
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:MSW, ACSW,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21907 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5104
Mailing Address - Country:US
Mailing Address - Phone:248-426-9900
Mailing Address - Fax:248-426-9950
Practice Address - Street 1:40000 GRAND RIVER AVE
Practice Address - Street 2:STE. 306
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2121
Practice Address - Country:US
Practice Address - Phone:248-426-9900
Practice Address - Fax:248-426-9950
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010116541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI047271OtherVALUE OPTIONS PROVIDER ID