Provider Demographics
NPI:1114682986
Name:BUDDINGTON, CARRIE MAE (LCSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:MAE
Last Name:BUDDINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 GRASMERE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-2212
Mailing Address - Country:US
Mailing Address - Phone:339-222-2891
Mailing Address - Fax:
Practice Address - Street 1:129 GRASMERE ST APT 1
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2212
Practice Address - Country:US
Practice Address - Phone:339-222-2891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0002275061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical