MEDICARE: MS. AMY B CAREY-DICARLO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	115542	MA
2	1041C0700X	Clinical Social Worker	115542	MA
3	1041C0700X	Clinical Social Worker	LC11412	ME
4	104100000X	Social Worker	LC11412	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	483127	OTHER		VALUE OPTIONS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P08110	OTHER	MA	BCBS

General Provider Information

NPI Number	:	1588639140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY B CAREY-DICARLO LCSW

Provider Business Mailing Address
First Line	:	469 MAIN ST STE 206
Second Line	:
City	:	SPRINGVALE
State	:	ME
Zip	:	04083-1871
Country	:	US
Telephone Number	:	781-985-3914
Fax Number	:

Provider Business Practice Location Address
First Line	:	469 MAIN ST STE 206
Second Line	:
City	:	SPRINGVALE
State	:	ME
Zip	:	04083-1871
Country	:	US
Telephone Number	:	781-985-3914
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	04/30/2024

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Directions to “ MS. AMY B CAREY-DICARLO LCSW” Practice Location

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