Provider Demographics
NPI:1902939671
Name:ALAIMO, CAROLYN ANN (PHD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANN
Last Name:ALAIMO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36400 WOODWARD AVE
Mailing Address - Street 2:SUITE 228
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-0911
Mailing Address - Country:US
Mailing Address - Phone:248-645-2835
Mailing Address - Fax:248-723-0097
Practice Address - Street 1:36400 WOODWARD AVE
Practice Address - Street 2:SUITE 228
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-0911
Practice Address - Country:US
Practice Address - Phone:248-645-2835
Practice Address - Fax:248-723-0097
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006565103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI680F391720OtherBCBSM
MI680F331970OtherBCBSM
MI680F391720OtherBCBSM
MIMI4216Medicare PIN