Provider Demographics
NPI:1356566491
Name:PAULDING, CAROL ROSS (LCPC)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ROSS
Last Name:PAULDING
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:BETSY
Other - Last Name:PAULDING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:21 QUIET LANE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2269
Mailing Address - Country:US
Mailing Address - Phone:207-878-1176
Mailing Address - Fax:
Practice Address - Street 1:56 WILLIAM STREET
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-4828
Practice Address - Country:US
Practice Address - Phone:207-878-1176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0793101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional