Provider Demographics
NPI:1407024193
Name:SMITH PICARIELLO, CARLA M (PHD)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:M
Last Name:SMITH PICARIELLO
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 1:7 CENTRAL ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4800
Mailing Address - Country:US
Mailing Address - Phone:781-646-7271
Mailing Address - Fax:978-486-0094
Practice Address - Street 1:7 CENTRAL ST
Practice Address - Street 2:SUITE 207
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4800
Practice Address - Country:US
Practice Address - Phone:781-646-7271
Practice Address - Fax:978-486-0094
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6664103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist