Provider Demographics
NPI:1487009874
Name:CARCAMO, ROXANNA A (LMSW)
Entity Type:Individual
Prefix:
First Name:ROXANNA
Middle Name:A
Last Name:CARCAMO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 BECK ST
Mailing Address - Street 2:1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-5103
Mailing Address - Country:US
Mailing Address - Phone:917-642-4066
Mailing Address - Fax:
Practice Address - Street 1:2 PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-3402
Practice Address - Country:US
Practice Address - Phone:917-642-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094413104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker