Individual
MS. CAROL S KRISHNAMOORTHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
79 MIDDLEVILLE RD, VAMC SOCIAL WORK & CHAPLAIN SERVICE (122), NORTHPORT, NY 11768-2200
(631) 261-4400
(631) 266-6029
Mailing address
46 WOODY LN, NORTHPORT, NY 11768-3255
(631) 261-4400
(631) 266-6029
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R012861-1
NY
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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