Individual
MARYANN J CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
LC8071
ME
103TC0700X
Clinical Psychologist
LC8071
ME
103TC1900X
Counseling Psychologist
LC8071
ME
1041C0700X
Clinical Social Worker
Primary
LC8071
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104760200
—
ME
05
—
104760201
—
ME
Enumeration date
08/01/2006
Last updated
08/06/2008
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