Provider Demographics
NPI:1083961478
Name:WOODWORTH, CAROLINE
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:
Last Name:WOODWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MAY ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-5119
Mailing Address - Country:US
Mailing Address - Phone:207-216-5045
Mailing Address - Fax:
Practice Address - Street 1:17 MAY ST APT 3
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-5119
Practice Address - Country:US
Practice Address - Phone:207-216-5045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical