Provider Demographics
NPI:1841360310
Name:EICHENMILLER, CARLA DENISE (LCSW-C)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:DENISE
Last Name:EICHENMILLER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:
Other - Last Name:ALVARADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:100 E. CARROLL STREET
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-0249
Mailing Address - Country:US
Mailing Address - Phone:410-543-7119
Mailing Address - Fax:
Practice Address - Street 1:100 E CARROLL ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5493
Practice Address - Country:US
Practice Address - Phone:800-749-5191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100601041C0700X, 101Y00000X
MD1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD609550001Medicaid
MD609550004Medicaid
MD244546ZAJJMedicare UPIN