Provider Demographics
NPI:1043795933
Name:CUNEO, CAROLYN L (LICSW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:L
Last Name:CUNEO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ONTARIO DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-3122
Mailing Address - Country:US
Mailing Address - Phone:978-562-9332
Mailing Address - Fax:
Practice Address - Street 1:58 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-3718
Practice Address - Country:US
Practice Address - Phone:978-970-5470
Practice Address - Fax:978-970-5466
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1117071041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool