Provider Demographics
NPI:1285844324
Name:MERLE-FISHMAN, CAROL R (LMHC, LCAT)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:R
Last Name:MERLE-FISHMAN
Suffix:
Gender:F
Credentials:LMHC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 LAKEVIEW AVE W
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-6415
Mailing Address - Country:US
Mailing Address - Phone:914-736-0218
Mailing Address - Fax:914-788-5732
Practice Address - Street 1:51 LAKEVIEW AVE W
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-6415
Practice Address - Country:US
Practice Address - Phone:914-736-0218
Practice Address - Fax:914-788-5732
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000760101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health