Provider Demographics
NPI:1275774580
Name:KERN, CAROLINE GOLDMACHER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:GOLDMACHER
Last Name:KERN
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 1:77 BROADVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-4114
Mailing Address - Country:US
Mailing Address - Phone:917-450-8510
Mailing Address - Fax:
Practice Address - Street 1:77 BROADVIEW AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-4114
Practice Address - Country:US
Practice Address - Phone:917-450-8510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069451-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical