Provider Demographics
NPI:1750400081
Name:ALBERT, CARYN MARNI (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CARYN
Middle Name:MARNI
Last Name:ALBERT
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 1:12 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1734
Mailing Address - Country:US
Mailing Address - Phone:516-801-3441
Mailing Address - Fax:
Practice Address - Street 1:12 JACKSON ST
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-1734
Practice Address - Country:US
Practice Address - Phone:516-801-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067983-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker