Provider Demographics
NPI:1871027680
Name:CARLONE, MARCYANNA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARCYANNA
Middle Name:
Last Name:CARLONE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 RUSSETT LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-5811
Mailing Address - Country:US
Mailing Address - Phone:860-463-9606
Mailing Address - Fax:
Practice Address - Street 1:112 RUSSETT LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-5811
Practice Address - Country:US
Practice Address - Phone:860-463-9606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional