Provider Demographics
NPI:1386731149
Name:CARBERRY, PATRICIA ANNE (MS, CAS, ABSNP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNE
Last Name:CARBERRY
Suffix:
Gender:F
Credentials:MS, CAS, ABSNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 TYLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-2926
Mailing Address - Country:US
Mailing Address - Phone:315-255-3941
Mailing Address - Fax:
Practice Address - Street 1:157 GENESEE STREET
Practice Address - Street 2:BASEMENT
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3461
Practice Address - Country:US
Practice Address - Phone:315-253-0341
Practice Address - Fax:315-253-1129
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health