Provider Demographics
NPI:1861643009
Name:CAREY, CAROLYN HUHTALA (MA)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:HUHTALA
Last Name:CAREY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 BOURDEAU RD
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:VT
Mailing Address - Zip Code:05753-9461
Mailing Address - Country:US
Mailing Address - Phone:802-462-2407
Mailing Address - Fax:
Practice Address - Street 1:10 MERCHANTS ROW
Practice Address - Street 2:SUITE 208
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753
Practice Address - Country:US
Practice Address - Phone:802-388-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT047-0000368103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist