Healthcare Provider Details

I. General information

NPI: 1558481085
Provider Name (Legal Business Name): CAROL MION LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 RIVERSIDE DR
BINGHAMTON NY
13905-4508
US

IV. Provider business mailing address

25 RITCHIE RD
BINGHAMTON NY
13901-1533
US

V. Phone/Fax

Practice location:
  • Phone: 607-221-5226
  • Fax:
Mailing address:
  • Phone: 607-221-5226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR035949-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: