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General NPI Number Information
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NPI Number | 1003578782
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Entity Type | Individual
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Provider Name | KELLY CARRONE LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/09/2021
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 404 ZENA RD STE 2
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City | WOODSTOCK
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State | NY
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Zip | 12498-2627
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Country | US
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Telephone | 845-679-8650
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Fax |
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Provider Business Mailing Address
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Address Line | 1475 WESTERN AVE STE 51-3844
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City | ALBANY
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State | NY
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Zip | 12203-3520
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Country | US
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Telephone | 518-545-4475
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 101455
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License Number State | NY
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