Carol J Persley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006087A Issued in IN

Practice address

550 S Adams St
Bloomington, IN 47403

Phone

(812) 333-6324

Fax

(812) 331-6700

NPI assigned

Sep 28, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Carol J Ray Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1215246129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S ADAMS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S ADAMS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "47403",
            "telephone_number": "812-333-6324",
            "fax_number": "812-331-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSLEY",
        "first_name": "CAROL",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006087A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "RAY",
            "middle_name": "J",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ian Perrotte
• Amali Perry
• Heather Perry, CTRS
• Molly Kestler Perry, LMHC
• Tashera Everlois Narcissa Perry
• Lainey Peter
• Allison V Peters, PA-C
• Asia Peters
• Jennifer Petersen-Goldspiel, M.D.
• Laura Petersen, LCSW

• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.