Provider Demographics
NPI:1376161281
Name:CARMONA, NELLY (LCSW)
Entity Type:Individual
Prefix:
First Name:NELLY
Middle Name:
Last Name:CARMONA
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 1:64 HATFIELD ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-1531
Mailing Address - Country:US
Mailing Address - Phone:413-977-2477
Mailing Address - Fax:
Practice Address - Street 1:241 KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2335
Practice Address - Country:US
Practice Address - Phone:413-341-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical