Provider Demographics
NPI:1568247096
Name:MUSCARELLA-SEBZDA, CARMEN MARIA (LCSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:MARIA
Last Name:MUSCARELLA-SEBZDA
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 1:38 CASTILE DR
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063-2333
Mailing Address - Country:US
Mailing Address - Phone:716-397-2311
Mailing Address - Fax:
Practice Address - Street 1:10674 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:GOWANDA
Practice Address - State:NY
Practice Address - Zip Code:14070-1344
Practice Address - Country:US
Practice Address - Phone:716-532-3325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0958061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical