Provider Demographics
NPI:1205030749
Name:MARKS-STOPFORTH, CAROL (LMHC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:MARKS-STOPFORTH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 CORNWALL ST APT 2
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2679
Mailing Address - Country:US
Mailing Address - Phone:617-797-0397
Mailing Address - Fax:617-773-6457
Practice Address - Street 1:233 HARVARD ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5069
Practice Address - Country:US
Practice Address - Phone:617-797-0397
Practice Address - Fax:617-773-6457
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA6416101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health