Provider Demographics
NPI:1740278365
Name:CARPENO, LINDA (EDD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:CARPENO
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 820
Mailing Address - Street 2:
Mailing Address - City:CATAUMET
Mailing Address - State:MA
Mailing Address - Zip Code:02534
Mailing Address - Country:US
Mailing Address - Phone:508-563-5242
Mailing Address - Fax:508-559-6143
Practice Address - Street 1:6 CHAUNCY WAY.
Practice Address - Street 2:
Practice Address - City:CATAUMET
Practice Address - State:MA
Practice Address - Zip Code:02534
Practice Address - Country:US
Practice Address - Phone:508-563-5242
Practice Address - Fax:508-559-6143
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2332103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
135007000OtherMAGELLAN BEHAVIORAL HEALT
MAW02488OtherBLUE CROSS BLUE SHIELD
MA724046OtherTUFTS HEALTH PLAN
MA724046OtherTUFTS HEALTH PLAN