| Doctor Name: | MS. CAROL MARIE RESSIDI CERVIA |
| NPI Number: | 1427239193 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CSW CASAC |
| License Number: | 055412 |
| Business Practice Address: | 1841 Bdwy 4th Flr Institute Of Contemperary Psychotherapy Nyc, NY - 10023 |
| Business Phone Number: | 2123333444 |
| Business Fax Number: | 2123335444 |
| Mailing Address: | 1841 Bdwy, 4th Flr Institute Of Contemperary Psychotherapy NYC |
| State: | NY |
| Postal Code: | 10023 |
| Phone Number: | 2123333444 |
| Fax Number: | 2123335444 |
| NPI Enumeration Date: | 11/21/2007 |
| NPI Last Update Date: | 11/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 055412 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |