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General NPI Number Information
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NPI Number | 1447307533
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Entity Type | Individual
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Provider Name | MARYELLEN CAGGIANO CARBAUGH LPCMH
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1132 S LITTLE CREEK RD
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City | DOVER
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State | DE
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Zip | 19901-4727
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Country | US
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Telephone | 302-734-7750
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Fax | 302-736-5265
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Provider Business Mailing Address
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Address Line | PO BOX 1155
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City | DOVER
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State | DE
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Zip | 19903-1155
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Country | US
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Telephone | 302-734-7750
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Fax | 302-736-5265
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC-0000238
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License Number State | DE
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