Deborah Jean Carpenter Wallace, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

50563 Issued in TX

Practice address

3 Courthouse Lane Suite 3
Chelmsford, MA 01824

Phone

(978) 256-1444

Fax

(978) 441-1773

NPI assigned

Oct 20, 2006

Last updated

Mar 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1942383427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 PARK ROAD 21",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760338561",
            "telephone_number": "817-875-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COURTHOUSE LANE SUITE 3",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "01824",
            "telephone_number": "978-256-1444",
            "fax_number": "978-441-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER WALLACE",
        "first_name": "DEBORAH",
        "middle_name": "JEAN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110823",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9859-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "50563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carewarden LLC
• Carewarden LLC
• Jennifer A Carey, PA
• Diana Gouveia Carlson, LICSW
• Caroline Mawanda PC
• Sarah Carpenter, LCSW 17820
• Elizabeth Ann Carrick
• Tayla Carroll, BCBA
• Jensine Casey
• Kisairis Miledy Castillo, BCBA

• Clinical Social Worker in Chelmsford, MA
• Providers in Chelmsford, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.