Provider Demographics
NPI:1659835452
Name:CARNEY, OLIVIA V
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:V
Last Name:CARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 ALDEN AVE APT B
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2139
Mailing Address - Country:US
Mailing Address - Phone:860-876-2650
Mailing Address - Fax:
Practice Address - Street 1:355 ALDEN AVE APT B
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-2139
Practice Address - Country:US
Practice Address - Phone:860-876-2650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health