Provider Demographics
NPI:1760602825
Name:MARCHILLO, CAROLYN LLOUISE (CASAC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:LLOUISE
Last Name:MARCHILLO
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5775
Mailing Address - Country:US
Mailing Address - Phone:518-587-5833
Mailing Address - Fax:
Practice Address - Street 1:433 GEYSER ROAD
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020
Practice Address - Country:US
Practice Address - Phone:518-885-6884
Practice Address - Fax:518-885-0077
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)