Provider Demographics
NPI:1699279851
Name:WILSON, MORAY CARLA (LICSW)
Entity type:Individual
Prefix:MS
First Name:MORAY
Middle Name:CARLA
Last Name:WILSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MARKET SQ APT 2
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2442
Mailing Address - Country:US
Mailing Address - Phone:617-721-1597
Mailing Address - Fax:
Practice Address - Street 1:12 MARKET SQ
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2442
Practice Address - Country:US
Practice Address - Phone:978-903-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1174481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical