Provider Demographics
NPI:1427207760
Name:OSORIO, JEAN CARLOS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEAN
Middle Name:CARLOS
Last Name:OSORIO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10814 72ND AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5301
Mailing Address - Country:US
Mailing Address - Phone:347-361-8428
Mailing Address - Fax:
Practice Address - Street 1:10814 72ND AVE STE 2
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5301
Practice Address - Country:US
Practice Address - Phone:347-361-8428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0864031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical