Provider Demographics
NPI:1922197052
Name:POECKING, CAROL E (LCSWR)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:E
Last Name:POECKING
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4086 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3022
Mailing Address - Country:US
Mailing Address - Phone:716-674-2206
Mailing Address - Fax:716-674-2415
Practice Address - Street 1:4086 SENECA ST
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3022
Practice Address - Country:US
Practice Address - Phone:716-674-2206
Practice Address - Fax:716-674-2415
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO26887-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000503192003OtherBCBS
NY000503192003OtherBCBS