Wallace, Carolyn Ann

Wallace, Carolyn Ann is an sole proprietor health care provider with primary practice located at 25 Middle St , Portland ME 04101-4869. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Wallace, Carolyn Ann can be contacted via phone (207) 653-3999.

Contact Information

Primary practice address
25 Middle St Portland ME 04101-4869
Phone: (207) 653-3999
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X XL3204 Maine
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LC4223 Maine

Profile Details

NPI number 1023141363
LBN Legal business name Wallace, Carolyn Ann
Credentials LCPCC, CADC, MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2007
Last updated Jan 27th, 2009 - about 17 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.

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