Provider Demographics
NPI:1427760578
Name:CARLSON, CAITLIN ALENE (LCSW-C)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ALENE
Last Name:CARLSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ALENE
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHP-S
Mailing Address - Street 1:350 MONTEVUE LN
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-8214
Mailing Address - Country:US
Mailing Address - Phone:301-600-1612
Mailing Address - Fax:301-600-3280
Practice Address - Street 1:350 MONTEVUE LN
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-8214
Practice Address - Country:US
Practice Address - Phone:301-600-1612
Practice Address - Fax:301-600-3280
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040131751041C0700X
MD316481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical