Individual
MR. CARMEN LICCIARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-R
Contact information
Practice address
16 PENN PLZ, NEW YORKER HOTEL SUITE 544, NEW YORK, NY 10001-1809
(732) 245-9364
Mailing address
930 YELLOWBANK RD, TOMS RIVER, NJ 08753-8614
(732) 245-9364
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
015545
NY
Other
Enumeration date
05/07/2008
Last updated
07/31/2012
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