Provider Demographics
NPI:1497017222
Name:CARRIERI, MICHELLE C (SPECIAL EDUCATOR, MS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:C
Last Name:CARRIERI
Suffix:
Gender:F
Credentials:SPECIAL EDUCATOR, MS
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:C
Other - Last Name:RADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED, LMSW
Mailing Address - Street 1:1083 MCDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2651
Mailing Address - Country:US
Mailing Address - Phone:718-421-7444
Mailing Address - Fax:718-421-7229
Practice Address - Street 1:1083 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2651
Practice Address - Country:US
Practice Address - Phone:718-421-7444
Practice Address - Fax:718-421-7229
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
NY089662104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No174400000XOther Service ProvidersSpecialist