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Individual

CAROLYN WOODWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC, LMHC

Contact information

Practice address
55 KESTREL LN, AMHERST, MA 01002-2840
(413) 253-8129
Mailing address
55 KESTREL LN, AMHERST, MA 01002-2840

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
000008947
MA
101YP2500X
Professional Counselor
CC4051
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1300881
MA
Enumeration date
07/21/2010
Last updated
04/02/2015
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