Provider Demographics
NPI:1619091592
Name:CARBONE, FRANK RAYMOND (MED, CAGS, LSW)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:RAYMOND
Last Name:CARBONE
Suffix:
Gender:M
Credentials:MED, CAGS, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 STONELEDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748-3720
Mailing Address - Country:US
Mailing Address - Phone:508-990-9921
Mailing Address - Fax:
Practice Address - Street 1:1 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3960
Practice Address - Country:US
Practice Address - Phone:508-828-9116
Practice Address - Fax:508-828-9146
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3018230101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health