Provider Demographics
NPI:1003144007
Name:LOONIE, CARLY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:
Last Name:LOONIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:
Other - Last Name:GIGLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27385 SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-5475
Mailing Address - Country:US
Mailing Address - Phone:516-220-0133
Mailing Address - Fax:
Practice Address - Street 1:13002 115TH AVE
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2122
Practice Address - Country:US
Practice Address - Phone:718-641-8933
Practice Address - Fax:718-641-8931
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079824104100000X
NY08046811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker