Provider Demographics
NPI:1093872053
Name:CARNES, MAUREEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:CARNES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 VINAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066
Mailing Address - Country:US
Mailing Address - Phone:781-545-1220
Mailing Address - Fax:781-545-4288
Practice Address - Street 1:77 VINAL AVE
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4225
Practice Address - Country:US
Practice Address - Phone:781-545-1220
Practice Address - Fax:781-545-4288
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7540103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW05896OtherBLUE CROSS
MA1890077Medicaid
MA1005740OtherBEACON HEALTH STRATEGIES