Provider Demographics
NPI:1588847792
Name:HATFIELD, CAROLYN H (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:H
Last Name:HATFIELD
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 1:16 LEROY PLACE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705
Mailing Address - Country:US
Mailing Address - Phone:914-844-6505
Mailing Address - Fax:
Practice Address - Street 1:256 WASHINGTON ST STE 2
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1056
Practice Address - Country:US
Practice Address - Phone:914-613-0700
Practice Address - Fax:914-273-7256
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087200-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01420795Medicaid