Provider Demographics
NPI:1477853240
Name:MUNSON, CARMEN (LMSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:MUNSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BLANCHARD HTS
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:NY
Mailing Address - Zip Code:13073-1220
Mailing Address - Country:US
Mailing Address - Phone:607-898-4126
Mailing Address - Fax:
Practice Address - Street 1:701 LENOX AVE
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-1500
Practice Address - Country:US
Practice Address - Phone:315-363-9281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058103104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker