Provider Demographics
NPI:1215263173
Name:WESTERDAHL, CAROL E (LCSW)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:E
Last Name:WESTERDAHL
Suffix:
Gender:F
Credentials:LCSW
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 145
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-0145
Mailing Address - Country:US
Mailing Address - Phone:207-694-1420
Mailing Address - Fax:207-521-5834
Practice Address - Street 1:52 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-2119
Practice Address - Country:US
Practice Address - Phone:207-694-1420
Practice Address - Fax:207-521-5834
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC142231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical