Individual
CAROL M LEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
211 CHURCH ST, CRAMER HOUSE, SARATOGA SPRINGS, NY 12866-1003
(518) 584-9030
(518) 581-1709
Mailing address
111 DIXON RD, QUEENSBURY, NY 12804-2132
(518) 361-0289
(518) 792-6235
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
070305-1
NY
1041C0700X
Clinical Social Worker
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00639496
—
NY
05
—
03199997
—
NY
Enumeration date
06/30/2006
Last updated
11/04/2011
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