Provider Demographics
NPI:1255481867
Name:CHASE, CAROLINE HEYWARD (MS LMHC)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:HEYWARD
Last Name:CHASE
Suffix:
Gender:F
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:MA
Mailing Address - Zip Code:01341
Mailing Address - Country:US
Mailing Address - Phone:413-625-2151
Mailing Address - Fax:
Practice Address - Street 1:161 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:MA
Practice Address - Zip Code:01341
Practice Address - Country:US
Practice Address - Phone:413-625-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4346101YM0800X
WALH00009280101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health