Provider Demographics
NPI:1568425528
Name:CERAME, CAROLYN MARTHA (LCSW CSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:MARTHA
Last Name:CERAME
Suffix:
Gender:F
Credentials:LCSW CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 ALEXANDER ST
Mailing Address - Street 2:NORMANDIE CARRIAGE HOUSE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2549
Mailing Address - Country:US
Mailing Address - Phone:585-251-7489
Mailing Address - Fax:585-381-0684
Practice Address - Street 1:253 ALEXANDER ST
Practice Address - Street 2:NORMANDIE CARRIAGE HOUSE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2549
Practice Address - Country:US
Practice Address - Phone:585-251-7489
Practice Address - Fax:585-381-0684
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03149311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
100395FKOtherPREF CARE
12075BMedicare ID - Type Unspecified