Provider Demographics
NPI:1689250979
Name:ASLAKSON-YARNAL, CARLA (LCSW)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:ASLAKSON-YARNAL
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:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:ALMOND
Mailing Address - State:NY
Mailing Address - Zip Code:14804-0040
Mailing Address - Country:US
Mailing Address - Phone:607-276-2071
Mailing Address - Fax:
Practice Address - Street 1:86 RIVER ST
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-2265
Practice Address - Country:US
Practice Address - Phone:607-282-5201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083813-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY16103993OtherALL OTHER INSURANCE
NY161039939Medicaid