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General NPI Number Information
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NPI Number | 1548405673
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Entity Type | Individual
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Provider Name | CARRIE ANN EDINGTON LMHC
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Gender | Female
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 21 W 2ND ST SUITE 6
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City | RIVERHEAD
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State | NY
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Zip | 11901-2752
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Country | US
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Telephone | 631-745-3748
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Fax |
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Provider Business Mailing Address
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Address Line | 21 W 2ND ST SUITE 6
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City | RIVERHEAD
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State | NY
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Zip | 11901-2752
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Country | US
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Telephone | 631-745-3748
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 004491
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License Number State | NY
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