Provider Demographics
NPI:1144737446
Name:CARLOUGH, MARY (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:CARLOUGH
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TURNHAM LN
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2615
Mailing Address - Country:US
Mailing Address - Phone:301-332-2202
Mailing Address - Fax:
Practice Address - Street 1:8030 WOODMONT AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3027
Practice Address - Country:US
Practice Address - Phone:301-519-8010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD094541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical