Provider Demographics
NPI:1932432739
Name:WORRELL, CAROLYN JEAN
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:JEAN
Last Name:WORRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 CASCADE PL
Mailing Address - Street 2:#201
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3126
Mailing Address - Country:US
Mailing Address - Phone:360-856-3054
Mailing Address - Fax:360-856-3065
Practice Address - Street 1:160 CASCADE PL
Practice Address - Street 2:#201
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3126
Practice Address - Country:US
Practice Address - Phone:360-856-3054
Practice Address - Fax:360-856-3065
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health