Provider Demographics
NPI:1487024113
Name:BEIVIDES, CARLOS ALEXANDER (LMSW)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:ALEXANDER
Last Name:BEIVIDES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BROADWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-1609
Mailing Address - Country:US
Mailing Address - Phone:212-951-6866
Mailing Address - Fax:
Practice Address - Street 1:32 BROADWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1609
Practice Address - Country:US
Practice Address - Phone:212-951-6866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA686381041C0700X
NY0989701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical