Provider Demographics
NPI:1003911173
Name:CARNEY, SUELLEN M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUELLEN
Middle Name:M
Last Name:CARNEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 66TH ST
Mailing Address - Street 2:#18K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6451
Mailing Address - Country:US
Mailing Address - Phone:212-772-1538
Mailing Address - Fax:212-772-1538
Practice Address - Street 1:201 E 66TH ST
Practice Address - Street 2:#18K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6451
Practice Address - Country:US
Practice Address - Phone:212-772-1538
Practice Address - Fax:212-772-1538
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0114721103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent