Provider Demographics
NPI:1942558481
Name:CARNES, STEPHANIE LAUREN (LMSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LAUREN
Last Name:CARNES
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 1:606 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-3915
Mailing Address - Country:US
Mailing Address - Phone:202-351-9176
Mailing Address - Fax:
Practice Address - Street 1:3125 ROUTE 9W STE 201
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6764
Practice Address - Country:US
Practice Address - Phone:202-351-9176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086647-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker