Individual ProviderCarmen LicciardoSocial WorkerBehavioral Health & Social Service ProvidersPractice Address16 Penn Plz, New Yorker Hotel Suite 544, New York, NY 10001-1809(732) 245-9364PECOS EnrollmentBased on the most recent information from CMS, provider Carmen Licciardo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 2:56 PM.Profile DetailsProvider ID1548436611Provider TypeIndividualFull NameLicciardo, CarmenTitleMr.CredentialLCSW-RGenderMaleSole ProprietorYesEnumeration Date5/7/2008Last Updated7/31/2012Contact InformationPractice LocationPractice Address16 Penn Plz, New Yorker Hotel Suite 544, New York, NY 10001-1809Phone(732) 245-9364FaxUnlisted FaxMailing LocationMailing Address930 Yellowbank Rd, Toms River, NJ 08753-8614Phone(732) 245-9364FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense015545New York