Provider Demographics
NPI:1699538090
Name:SANTANA, CAROLYN J (MHC-LP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:J
Last Name:SANTANA
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 MARKET ST STE 376
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-7619
Mailing Address - Country:US
Mailing Address - Phone:914-327-2835
Mailing Address - Fax:914-327-2844
Practice Address - Street 1:73 MARKET ST STE 376
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7619
Practice Address - Country:US
Practice Address - Phone:914-327-2835
Practice Address - Fax:914-327-2844
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2599353101YS0200X
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool