MEDICARE: MS. CAROL BERLIND LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	077422-1	NY

General Provider Information

NPI Number	:	1407900707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL BERLIND LCSW

Provider Business Mailing Address
First Line	:	27 MT HOLLY RD E
Second Line	:
City	:	KATONAH
State	:	NY
Zip	:	10536-2400
Country	:	US
Telephone Number	:	914-668-8938
Fax Number	:	914-668-2545

Provider Business Practice Location Address
First Line	:	6 GRAMATAN AVE
Second Line	:	SUITE 401
City	:	MT VERNON
State	:	NY
Zip	:	10550-3208
Country	:	US
Telephone Number	:	914-668-8938
Fax Number	:	914-668-2545

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	04/22/2010

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