Provider Demographics
NPI:1942596010
Name:CARABALLO, ANN E (LICSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:E
Last Name:CARABALLO
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 1:372 WEST ST STE 102
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-2412
Mailing Address - Country:US
Mailing Address - Phone:603-338-0033
Mailing Address - Fax:
Practice Address - Street 1:372 WEST ST STE 102
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2412
Practice Address - Country:US
Practice Address - Phone:603-338-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical