Provider Demographics
NPI:1437233673
Name:SAYLE, CAROLE (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:
Last Name:SAYLE
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:PO BOX 892
Mailing Address - Street 2:
Mailing Address - City:TANNERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12485-0892
Mailing Address - Country:US
Mailing Address - Phone:518-589-9739
Mailing Address - Fax:518-589-0320
Practice Address - Street 1:93 SUNSET AVENUE
Practice Address - Street 2:
Practice Address - City:TANNERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12485
Practice Address - Country:US
Practice Address - Phone:518-589-9739
Practice Address - Fax:518-589-0320
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0408011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY137975OtherVALUE OPTIONS
NV617231OtherMVP HEALTH CARE
NY7479584OtherGHI/EMPIRE PLAN
NYNF0241Medicare ID - Type Unspecified