Provider Demographics
NPI:1336731132
Name:CARNEY, SHANELL (LMSW)
Entity Type:Individual
Prefix:MS
First Name:SHANELL
Middle Name:
Last Name:CARNEY
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 1:13 ABBIE LN
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-2201
Mailing Address - Country:US
Mailing Address - Phone:845-706-8583
Mailing Address - Fax:
Practice Address - Street 1:13 ABBIE LN
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:12538-2201
Practice Address - Country:US
Practice Address - Phone:845-706-8583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100394-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical