Provider Demographics
NPI:1942796719
Name:AUSTIN, CAROL LYNN (RSW)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:LYNN
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:RSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 181
Mailing Address - Street 2:
Mailing Address - City:HAHNVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70057-0181
Mailing Address - Country:US
Mailing Address - Phone:985-244-0582
Mailing Address - Fax:
Practice Address - Street 1:517 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:HAHNVILLE
Practice Address - State:LA
Practice Address - Zip Code:70057
Practice Address - Country:US
Practice Address - Phone:985-244-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-05
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14058172V00000X
104100000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker