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NPI Code Detail

MEDICARE: KIM DECARLO LCSW

MEDICARE: KIM DECARLO 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
11041C0700XClinical Social WorkerLC25368ME

General Provider Information

NPI Number : 1093496416
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM DECARLO LCSW
Provider Business Mailing Address
First Line : PO BOX 128
Second Line :
City : YARMOUTH
State : ME
Zip : 04096-0128
Country : US
Telephone Number : 207-200-1096
Fax Number :
Provider Business Practice Location Address
First Line : 173 GRAY RD
Second Line :
City : FALMOUTH
State : ME
Zip : 04105-2514
Country : US
Telephone Number : 914-552-7144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2023
Last Update Date : 01/21/2026

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Directions to “ KIM DECARLO LCSW” Practice Location

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