Provider Demographics
NPI:1740911676
Name:FOTI, CARMEN (LICSW)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:FOTI
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 1:53 OLD COACH RD
Mailing Address - Street 2:
Mailing Address - City:ATKINSON
Mailing Address - State:NH
Mailing Address - Zip Code:03811-2324
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:53 OLD COACH RD
Practice Address - Street 2:
Practice Address - City:ATKINSON
Practice Address - State:NH
Practice Address - Zip Code:03811-2324
Practice Address - Country:US
Practice Address - Phone:978-500-6681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1247881041C0700X
NH27131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical