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General NPI Number Information
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NPI Number | 1477707578
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Entity Type | Individual
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Provider Name | CARLA LYNN MANNINO LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 405 LEXINGTON AVE STE 2606
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City | NEW YORK
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State | NY
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Zip | 10174-0002
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Country | US
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Telephone | 212-810-1724
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Fax |
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Provider Business Mailing Address
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Address Line | 405 LEXINGTON AVE STE 2606
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City | NEW YORK
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State | NY
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Zip | 10174-0002
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Country | US
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Telephone | 212-810-1724
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05914700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 000122993
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 95072
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10811
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R0794891
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW16758
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 077578
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License Number State | NY
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