Provider Demographics
NPI:1336684042
Name:STUART-CAINES, HOLLY
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:STUART-CAINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:STUART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:252 JAVA ST STE 213
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-5519
Mailing Address - Country:US
Mailing Address - Phone:718-612-7618
Mailing Address - Fax:
Practice Address - Street 1:252 JAVA ST STE 213
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-5519
Practice Address - Country:US
Practice Address - Phone:718-612-7618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2023-10-10
Deactivation Date:2023-10-04
Deactivation Code:
Reactivation Date:2023-10-10
Provider Licenses
StateLicense IDTaxonomies
NY0819731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical