Provider Demographics
NPI:1295178176
Name:CARLIN, MARY E (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:CARLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 W. 9TH STREET
Mailing Address - Street 2:SUITE 9D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8920
Mailing Address - Country:US
Mailing Address - Phone:718-797-1583
Mailing Address - Fax:718-431-0416
Practice Address - Street 1:26 W. 9TH STREET
Practice Address - Street 2:SUITE 9D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8920
Practice Address - Country:US
Practice Address - Phone:718-797-1583
Practice Address - Fax:718-431-0416
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010702-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical