Individual
CARLY CANNAVINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGPC
Contact information
Practice address
6110 EXECUTIVE BLVD STE 540, NORTH BETHESDA, MD 20852-3948
(202) 750-1028
Mailing address
148 SUN VALLEY WAY, MORRIS PLAINS, NJ 07950-2042
(973) 452-7300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGPC200002983
DC
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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