Provider Demographics
NPI:1780378463
Name:CARRIE I. EDICK N.P., IN PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:CARRIE I. EDICK N.P., IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDICK
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PMHNP-BC, DNP
Authorized Official - Phone:518-788-7983
Mailing Address - Street 1:430 FRANKLIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-2018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:430 FRANKLIN ST FL 2
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12305-2018
Practice Address - Country:US
Practice Address - Phone:518-788-7983
Practice Address - Fax:866-256-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health