Elizondo, Carmen E.

Elizondo, Carmen E. is an individual health care provider with primary practice located at 155 Crystal Run Rd , Middletown NY 10941-4028. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Elizondo, Carmen E. can be contacted via phone (845) 703-6999.

Contact Information

Primary practice address
155 Crystal Run Rd Middletown NY 10941-4028
Fax: (845) 703-6297
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X RO29929-1 New York

Profile Details

NPI number 1073679619
LBN Legal business name Elizondo, Carmen E.
Credentials LCSW-PSY.D
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Apr 4th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073679619 NPPES
New York MEDICAID 020227847

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