Provider Demographics
NPI:1407189046
Name:PLANK, CAREN MARCIA (LCPC,LMFT,LMHC)
Entity Type:Individual
Prefix:MS
First Name:CAREN
Middle Name:MARCIA
Last Name:PLANK
Suffix:
Gender:F
Credentials:LCPC,LMFT,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 RED BARN RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:ME
Mailing Address - Zip Code:04951-3141
Mailing Address - Country:US
Mailing Address - Phone:207-322-1646
Mailing Address - Fax:
Practice Address - Street 1:156 RED BARN RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:ME
Practice Address - Zip Code:04951-3141
Practice Address - Country:US
Practice Address - Phone:207-322-1646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251101YP2500X
MECC3345101YP2500X
MA170106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist