Provider Demographics
NPI:1447317417
Name:SUTCLIFFE, CAROL A (LMHC, LCMHC, NCC)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:A
Last Name:SUTCLIFFE
Suffix:
Gender:F
Credentials:LMHC, LCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 710
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NH
Mailing Address - Zip Code:03032-0710
Mailing Address - Country:US
Mailing Address - Phone:978-794-9968
Mailing Address - Fax:978-794-8123
Practice Address - Street 1:599 CANAL STREET
Practice Address - Street 2:SUITE #5W 14-15
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840
Practice Address - Country:US
Practice Address - Phone:978-794-9968
Practice Address - Fax:978-794-8123
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2011-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3913101YM0800X
NH882101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1890107Medicaid