Individual
MS. CAROLYN KENYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1000 CAYUGA HEIGHTS RD, ITHACA, NY 14850-1035
(607) 277-3014
Mailing address
1000 CAYUGA HEIGHTS RD, ITHACA, NY 14850-1035
(607) 277-3014
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PR018206-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
158892
VALUE OPTIONS
NY
01
—
AETNA
4273943
NY
Enumeration date
10/10/2006
Last updated
07/08/2007
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