Healthcare Provider Details
I. General information
NPI: 1023929486
Provider Name (Legal Business Name): K CARSON PSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
549 SAW MILL RIVER RD
MILLWOOD NY
10546-1020
US
IV. Provider business mailing address
72 N STATE RD
BRIARCLIFF MANOR NY
10510-1414
US
V. Phone/Fax
- Phone: 203-687-5760
- Fax:
- Phone: 203-687-5760
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KAITLIN
CARSON
Title or Position: DIRECTOR
Credential: PHD
Phone: 203-687-5760