Provider Demographics
NPI:1396197364
Name:BONCARDO, CARISSA (LMHC)
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:
Last Name:BONCARDO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 E BOSTON POST RD STE 206
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3704
Mailing Address - Country:US
Mailing Address - Phone:914-236-5097
Mailing Address - Fax:347-348-0678
Practice Address - Street 1:444 E BOSTON POST RD STE 206
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3704
Practice Address - Country:US
Practice Address - Phone:914-236-5097
Practice Address - Fax:347-348-0678
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health