Provider Demographics
NPI:1700243797
Name:HUNTINGTON, CAROL (LCSW)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:HUNTINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BOWERY ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2816
Mailing Address - Country:US
Mailing Address - Phone:207-751-3363
Mailing Address - Fax:
Practice Address - Street 1:121 BOWERY ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2816
Practice Address - Country:US
Practice Address - Phone:207-751-3363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC77851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME102140100Medicaid