Provider Demographics
NPI:1063633956
Name:SPERO, CAROL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:
Last Name:SPERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 YORK AVE
Mailing Address - Street 2:APT 8D
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7809
Mailing Address - Country:US
Mailing Address - Phone:212-746-3804
Mailing Address - Fax:212-746-6168
Practice Address - Street 1:430 EAST 86TH STREET
Practice Address - Street 2:SUITE 1F
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:212-746-3804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR00784311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN48412Medicare ID - Type Unspecified