Provider Demographics
NPI:1487068912
Name:COMAS, CAROLYN (LCSW)
Entity type:Individual
Prefix:MISS
First Name:CAROLYN
Middle Name:
Last Name:COMAS
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 1:1920 HILLHURST AVE # 1094
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-2712
Mailing Address - Country:US
Mailing Address - Phone:631-275-1929
Mailing Address - Fax:
Practice Address - Street 1:2973 SUNNYNOOK DR.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039
Practice Address - Country:US
Practice Address - Phone:631-275-1929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA822621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty