Healthcare Provider Details

I. General information

NPI: 1629602768
Provider Name (Legal Business Name): CARRIE ANN GAJOWSKI LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GROSSMAN DR # 1250
BRAINTREE MA
02184-4967
US

IV. Provider business mailing address

500 GROSSMAN DR # 1250
BRAINTREE MA
02184-4967
US

V. Phone/Fax

Practice location:
  • Phone: 323-207-8857
  • Fax:
Mailing address:
  • Phone: 925-408-7182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number129824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: