Provider Demographics
NPI:1104789593
Name:MAILHOIT, CARRIE A (LSW)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:A
Last Name:MAILHOIT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 POND ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4322
Mailing Address - Country:US
Mailing Address - Phone:978-491-7604
Mailing Address - Fax:
Practice Address - Street 1:50 DUNHAM RIDGE RD
Practice Address - Street 2:SUITE 3200-3350
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-600-0816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALSW3032623104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker