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General NPI Number Information
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NPI Number | 1467852434
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Entity Type | Individual
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Provider Name | CHERYL ANN CARROLL LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 391 VARNUM AVE
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City | LOWELL
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State | MA
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Zip | 01854-2119
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Country | US
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Telephone | 978-703-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 307 AMHERST ST # 12
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City | NASHUA
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State | NH
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Zip | 03063-1747
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Country | US
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Telephone | 603-913-4289
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 220299
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2050
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License Number State | NH
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