Provider Demographics
NPI:1417028721
Name:RICE, CARLA LEE (MA, LMSW)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:LEE
Last Name:RICE
Suffix:
Gender:F
Credentials:MA, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 DILTZ RD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2719
Mailing Address - Country:US
Mailing Address - Phone:845-826-5947
Mailing Address - Fax:718-583-4080
Practice Address - Street 1:2021 GRAND CONCOURSE FL 8
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4304
Practice Address - Country:US
Practice Address - Phone:718-960-0367
Practice Address - Fax:718-583-4080
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058886104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker