Provider Demographics
NPI:1548601008
Name:ORTIZ, CARLOS D (LMHC)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:D
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2429 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2801
Mailing Address - Country:US
Mailing Address - Phone:347-305-7200
Mailing Address - Fax:718-518-7647
Practice Address - Street 1:2429 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2801
Practice Address - Country:US
Practice Address - Phone:347-305-7200
Practice Address - Fax:718-518-7647
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health