Provider Demographics
NPI:1982799060
Name:MEYERS, CAROLE ELAYNE (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:ELAYNE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 INNINGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-2203
Mailing Address - Country:US
Mailing Address - Phone:914-941-6637
Mailing Address - Fax:
Practice Address - Street 1:21 INNINGWOOD RD
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-2203
Practice Address - Country:US
Practice Address - Phone:914-941-6637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO15635-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNE8591Medicare ID - Type Unspecified