Provider Demographics
NPI:1407331846
Name:ARROYO, ERNESTO (LMSW)
Entity Type:Individual
Prefix:
First Name:ERNESTO
Middle Name:
Last Name:ARROYO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:ERNESTO
Other - Middle Name:
Other - Last Name:ARROYO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8710 34TH AVE APT 6J
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-3345
Mailing Address - Country:US
Mailing Address - Phone:917-863-7179
Mailing Address - Fax:
Practice Address - Street 1:19 W 34TH ST RM 1200
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3006
Practice Address - Country:US
Practice Address - Phone:929-268-4230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079180-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00000000Medicaid