Individual
MRS. CAROLYN A FAHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
228 KINGS HWY EAST SUITE 101, HADDONFIELD, NJ 08033
(856) 216-8111
Mailing address
223 MIMOSA DR, CHERRY HILL, NJ 08003-1334
(856) 816-0280
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SCO5217600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
273844646
MAGELLAN
NJ
05
—
273844646
—
NJ
Enumeration date
10/11/2012
Last updated
10/11/2012
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