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General NPI Number Information
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NPI Number | 1275935330
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Entity Type | Organization
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Legal Business Name | CAROLE B. OKUN, LCSW-R
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 110 W BAY PLZ
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City | PLATTSBURGH
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State | NY
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Zip | 12901-1785
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Country | US
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Telephone | 518-570-0913
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Fax |
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Provider Business Mailing Address
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Address Line | 110 W BAY PLZ
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City | PLATTSBURGH
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State | NY
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Zip | 12901-1785
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Country | US
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Telephone | 518-570-0913
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MS. CAROLE B OKUN
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Credential | LCSW-R
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Telephone | 518-570-0913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R055184-1
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License Number State | NY
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