Provider Demographics
NPI:1902333081
Name:LEMPERT, CAROLYN SUSAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:SUSAN
Last Name:LEMPERT
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 1:4609 MILES STANDISH RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-4932
Mailing Address - Country:US
Mailing Address - Phone:757-773-3649
Mailing Address - Fax:
Practice Address - Street 1:5000 CORPORATE WOODS DR STE 500
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-4429
Practice Address - Country:US
Practice Address - Phone:757-321-2242
Practice Address - Fax:757-321-2236
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904009401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA090400940OtherLCSW
VA090400940OtherLICENSED CLINICAL SOCIAL WORKER