Provider Demographics
NPI:1326034315
Name:MUSUMECI, CAROLE LEE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:LEE
Last Name:MUSUMECI
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 1:304 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-3623
Mailing Address - Country:US
Mailing Address - Phone:516-429-6142
Mailing Address - Fax:
Practice Address - Street 1:304 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3623
Practice Address - Country:US
Practice Address - Phone:516-429-6142
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053050-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNG3951Medicare ID - Type UnspecifiedLCSW