Provider Demographics
NPI:1801125364
Name:DECHAINE, CAROLYN (LMSW)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:DECHAINE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2047 GALISTEO ST
Mailing Address - Street 2:SUITE B3
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-2101
Mailing Address - Country:US
Mailing Address - Phone:505-471-1184
Mailing Address - Fax:505-629-1586
Practice Address - Street 1:2047 GALISTEO ST
Practice Address - Street 2:SUITE B3
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2101
Practice Address - Country:US
Practice Address - Phone:505-471-1184
Practice Address - Fax:505-629-1586
Is Sole Proprietor?:No
Enumeration Date:2009-12-12
Last Update Date:2009-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-06765104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker