Blackburn, Carolyn W
Blackburn, Carolyn W is an individual health care provider with primary practice located at 329 Bath Rd , Brunswick ME 04011-2673. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Blackburn, Carolyn W can be contacted via phone (207) 373-3070.Contact Information
Primary practice address
329 Bath Rd
Brunswick ME 04011-2673
Phone: (207) 373-3070
Fax: (207) 373-3070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LC7316 | Maine |
Profile Details
| NPI number | 1669472247 |
|---|---|
| LBN Legal business name | Blackburn, Carolyn W |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2005 |
| Last updated | Aug 18th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669472247 | NPPES |
| Maine | MEDICAID | 287340099 |
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