Individual
LYNN RAE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
415 WATER ST, ELLSWORTH, ME 04605-2116
(207) 667-5357
Mailing address
43 SIS PORTER ROAD, SEDGWICK, ME 04676
(207) 326-9179
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LMHC - 0097841
NM
101YM0800X
Mental Health Counselor
Primary
CC3486
ME
104100000X
Social Worker
LS3891
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17384265
—
NM
Enumeration date
11/08/2006
Last updated
01/24/2012
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