MEDICARE: MS. KAREN LYNN CARSLEY LCSW-R

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	101YM0800X	Mental Health Counselor	R048900	NY

General Provider Information

NPI Number	:	1699950386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN LYNN CARSLEY LCSW-R

Provider Business Mailing Address
First Line	:	201 E 16TH ST
Second Line	:	SUITE 3B
City	:	NEW YORK
State	:	NY
Zip	:	10003-3706
Country	:	US
Telephone Number	:	212-677-1501
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 E 16TH ST FL 3B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-3706
Country	:	US
Telephone Number	:	212-677-1501
Fax Number	:	212-677-1501

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

Provider Enumeration Date	:	01/01/2008
Last Update Date	:	01/01/2008

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