Individual
CARA E GOEDEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1400 NOYES ST, - YORK STREET, UTICA, NY 13502-3854
(315) 738-4440
(315) 738-4410
Mailing address
1400 NOYES ST, - YORK STREET, UTICA, NY 13502-3854
(315) 738-4440
(315) 738-4410
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
72082268
NY
1041C0700X
Clinical Social Worker
Primary
73082734
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295175867
AGENCY NPI
NY
Enumeration date
04/19/2012
Last updated
08/13/2015
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