Provider Demographics
NPI:1669634895
Name:DONAHUE LIPUMA, CARRIE (LMSW)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:DONAHUE LIPUMA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MILTON RD
Mailing Address - Street 2:G-11
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3850
Mailing Address - Country:US
Mailing Address - Phone:914-473-2826
Mailing Address - Fax:
Practice Address - Street 1:66 MILTON RD
Practice Address - Street 2:G-11
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3850
Practice Address - Country:US
Practice Address - Phone:914-473-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060241-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical