Healthcare Provider Details

I. General information

NPI: 1619913258
Provider Name (Legal Business Name): KARNER PSYCHOLOGICAL ASSOCIATES,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2280 WESTERN AVE
GUILDERLAND NY
12084
US

IV. Provider business mailing address

2280 WESTERN AVE
GUILDERLAND NY
12084
US

V. Phone/Fax

Practice location:
  • Phone: 518-456-5056
  • Fax: 518-456-6512
Mailing address:
  • Phone: 518-456-5056
  • Fax: 518-456-6512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: SUSIE CAPOCCIA
Title or Position: CREDENTIALING
Credential:
Phone: 480-797-1571