Provider Demographics
NPI:1932329455
Name:IRELAND, CAROL LUCILLE (LCSW C MSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:LUCILLE
Last Name:IRELAND
Suffix:
Gender:F
Credentials:LCSW C MSW
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:IRELAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW C
Mailing Address - Street 1:106 MILFORD STREET
Mailing Address - Street 2:SUITE 501-B
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804
Mailing Address - Country:US
Mailing Address - Phone:757-336-3027
Mailing Address - Fax:
Practice Address - Street 1:106 MILFORD STREET
Practice Address - Street 2:SUITE 501-B
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804
Practice Address - Country:US
Practice Address - Phone:410-641-3121
Practice Address - Fax:410-641-4496
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07870104100000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
241LMedicare ID - Type Unspecified