Provider Demographics
NPI:1518140037
Name:MULTARI, CARRIE ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANNE
Last Name:MULTARI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:ANNE
Other - Last Name:HEPPERLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:713 UNION ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-3001
Mailing Address - Country:US
Mailing Address - Phone:518-828-4619
Mailing Address - Fax:518-828-1196
Practice Address - Street 1:713 UNION ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-3001
Practice Address - Country:US
Practice Address - Phone:518-828-4619
Practice Address - Fax:518-828-1196
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071792-1104100000X
NY0806671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI20140612001818OtherMEDICARE ENROLLMENT ID