Provider Demographics
NPI:1548316953
Name:CARSKY, MONICA (PHD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CARSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:ANNE
Other - Last Name:CARSKY KENNEDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:182 VANDELINDA AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-7242
Mailing Address - Country:US
Mailing Address - Phone:201-692-1336
Mailing Address - Fax:201-836-4688
Practice Address - Street 1:182 VANDELINDA AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-7242
Practice Address - Country:US
Practice Address - Phone:201-692-1336
Practice Address - Fax:201-836-4688
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2009-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ355100149100103T00000X, 103TC0700X, 103TH0100X
NY0062281103T00000X, 103TC0700X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCA650300OtherMEDICARE
NJCA650300OtherMEDICARE