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General NPI Number Information
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NPI Number | 1972037224
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Entity Type | Individual
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Provider Name | TAMMY CARLILE LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 310 WASHINGTON AVENUE EXT
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City | SAUGERTIES
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State | NY
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Zip | 12477-5222
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Country | US
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Telephone | 845-247-6500
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Fax | 845-246-4103
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Provider Business Mailing Address
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Address Line | 310 WASHINGTON AVENUE EXT
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City | SAUGERTIES
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State | NY
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Zip | 12477-5222
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Country | US
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Telephone | 845-247-6500
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Fax | 458-246-4103
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 086301
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License Number State | NY
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