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Individual

CAROL SOLDEVILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
4 S SPOONER ST, PLYMOUTH, MA 02360-4447
(508) 617-0070
Mailing address
362 COURT ST, PLYMOUTH, MA 02360-4397
(508) 617-0070

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
115897
MA
1041C0700X
Clinical Social Worker
115897
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046002284
MA
Enumeration date
03/19/2012
Last updated
01/09/2015
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