Provider Demographics
NPI:1669752762
Name:BURDETT, CAROLINE (LMSW)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BURDETT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 WALL ST STE 3
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3849
Mailing Address - Country:US
Mailing Address - Phone:845-795-8030
Mailing Address - Fax:
Practice Address - Street 1:291 WALL ST STE 3
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3849
Practice Address - Country:US
Practice Address - Phone:845-795-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker