Provider Demographics
NPI:1740338474
Name:CARNEY, MILDRED IRENE (MS, LMHC)
Entity type:Individual
Prefix:MS
First Name:MILDRED
Middle Name:IRENE
Last Name:CARNEY
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:MS
Other - First Name:MIDGE
Other - Middle Name:IRENE
Other - Last Name:CARNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LMHC
Mailing Address - Street 1:821 MOUNT TABOR RD STE 203
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-6410
Mailing Address - Country:US
Mailing Address - Phone:812-949-4900
Mailing Address - Fax:812-949-4903
Practice Address - Street 1:821 MOUNT TABOR RD STE 203
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6410
Practice Address - Country:US
Practice Address - Phone:812-949-4900
Practice Address - Fax:812-949-4903
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001522A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health