Provider Demographics
NPI:1053631812
Name:ALLEN-BOOKER, MARCIA (LMSW, CASAC)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:ALLEN-BOOKER
Suffix:
Gender:F
Credentials:LMSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-3436
Mailing Address - Country:US
Mailing Address - Phone:347-547-3626
Mailing Address - Fax:347-547-3609
Practice Address - Street 1:249 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-3436
Practice Address - Country:US
Practice Address - Phone:347-547-3626
Practice Address - Fax:347-547-3609
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7069101YA0400X
NY080087-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker