Individual
MS. CAROL ELLEN WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
47 KELSEY AVENUE, HUNTINGTON, NY 11746-1109
(631) 988-7316
Mailing address
47 KELSEY AVENUE, HUNTINGTON, NY 11746-1109
(631) 988-7316
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
072261
NY
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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