Individual
DR. IAN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-4141
Mailing address
462 1ST AVE, NEW YORK, NY 10016-9196
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
025261
NY
Other
Enumeration date
09/06/2017
Last updated
10/04/2022
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