Provider Demographics
NPI:1376664714
Name:CARLIN, CELESTINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CELESTINE
Middle Name:
Last Name:CARLIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:
Other - Last Name:CARLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:225 MCKINLEY TER
Mailing Address - Street 2:
Mailing Address - City:CENTERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11721-1311
Mailing Address - Country:US
Mailing Address - Phone:631-423-6404
Mailing Address - Fax:
Practice Address - Street 1:225 MCKINLEY TER
Practice Address - Street 2:
Practice Address - City:CENTERPORT
Practice Address - State:NY
Practice Address - Zip Code:11721-1311
Practice Address - Country:US
Practice Address - Phone:631-423-6404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0390091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical