Provider Demographics
NPI:1144379579
Name:MARKSON, CARYN (EDD)
Entity Type:Individual
Prefix:DR
First Name:CARYN
Middle Name:
Last Name:MARKSON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 54
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01061-0054
Mailing Address - Country:US
Mailing Address - Phone:413-585-1130
Mailing Address - Fax:
Practice Address - Street 1:151 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3128
Practice Address - Country:US
Practice Address - Phone:413-585-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4461103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW04319Medicare ID - Type UnspecifiedPSYCHOLOGIST