Provider Demographics
NPI:1184890352
Name:BEALS, CAROLE T (LICSW)
Entity type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:T
Last Name:BEALS
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 1:1043 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1512
Mailing Address - Country:US
Mailing Address - Phone:508-264-6992
Mailing Address - Fax:617-507-7686
Practice Address - Street 1:1043 CENTER ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1512
Practice Address - Country:US
Practice Address - Phone:508-264-6992
Practice Address - Fax:617-507-7686
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW031551041C0700X
1041C0700X
MA1160641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical