Carolyn Jane Kildegaard, MA
Individual provider Active NPI Mental Health Counselor · Vineyard Haven, MA
NPI 1669780870 · NPPES record last updated Sep 22, 2010
Key facts
- NPI
- 1669780870
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 111 Edgartown Road
Vineyard Haven, MA 02568 - Phone
- (508) 693-7900
- NPI assigned
- Sep 22, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
111 Edgartown Road
Vineyard Haven, MA 02568
Mailing address
PO Box 1385
Edgartown, MA 02539-1385
Phone (508) 693-7900
Other providers in Vineyard Haven, MA
- Jane McNulty
- John Curelli
- Saundra Hart Johnson
- Catherine Keller
- Patricia Marie Keohane
- Lydia Catherine Kingsbury
- Alexander Kisselgof
- April Knight
- Kathleen E Koehler
- Fae E Kontje-Gibbs
All providers in Vineyard Haven, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.