Healthcare Provider Details

I. General information

NPI: 1013623685
Provider Name (Legal Business Name): CARLI LYNN VOORIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 GREAT OAKS BLVD STE 215
ALBANY NY
12203-5969
US

IV. Provider business mailing address

34 NEW YORK AVE
RENSSELAER NY
12144-3309
US

V. Phone/Fax

Practice location:
  • Phone: 518-218-1188
  • Fax:
Mailing address:
  • Phone: 518-925-1767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number117809
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: