| Doctor Name: | MARY DECAROLIS |
| NPI Number: | 1003026089 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.M.S.W., A.C.S.W. |
| License Number: | 6801077436 |
| Business Practice Address: | 22101 Moross Rd Detroit, MI - 482362148 |
| Business Phone Number: | 3133437478 |
| Business Fax Number: | |
| Mailing Address: | 24634 N Meadow Dr, HARRISON TOWNSHIP |
| State: | MI |
| Postal Code: | 480453129 |
| Phone Number: | 5866753790 |
| Fax Number: | |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 03/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6801077436 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |