Provider Demographics
NPI:1649388042
Name:CARMEL, WANDA J (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:WANDA
Middle Name:J
Last Name:CARMEL
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CLOVER PARK DR. APARTMENT 2
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-4523
Mailing Address - Country:US
Mailing Address - Phone:585-386-3249
Mailing Address - Fax:
Practice Address - Street 1:12 CLOVER PARK DR. APARTMENT 2
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4523
Practice Address - Country:US
Practice Address - Phone:585-386-3249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0518001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical