Provider Demographics
NPI:1790854008
Name:CARPENTER, ANN MARIE LAPIERRE (LICSW)
Entity Type:Individual
Prefix:
First Name:ANN MARIE
Middle Name:LAPIERRE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 BENEDICT RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-2806
Mailing Address - Country:US
Mailing Address - Phone:413-447-9108
Mailing Address - Fax:413-445-6242
Practice Address - Street 1:333 EAST ST
Practice Address - Street 2:BRIEN CENTER
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5369
Practice Address - Country:US
Practice Address - Phone:413-499-0412
Practice Address - Fax:413-445-6242
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10153861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP21481Medicare ID - Type Unspecified