Provider Demographics
NPI:1275208308
Name:CARDEN, EMILY MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:CARDEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 INDIGO DR
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28555-9162
Mailing Address - Country:US
Mailing Address - Phone:130-430-8501
Mailing Address - Fax:
Practice Address - Street 1:111 INDIGO DR
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28555-9162
Practice Address - Country:US
Practice Address - Phone:130-430-8501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0135051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty