Provider Demographics
NPI:1558505479
Name:CLAUDIO, CARMEN (LCSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:CLAUDIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 W BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4015
Mailing Address - Country:US
Mailing Address - Phone:718-716-4400
Mailing Address - Fax:718-228-7471
Practice Address - Street 1:25 E 183RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-1242
Practice Address - Country:US
Practice Address - Phone:718-839-8900
Practice Address - Fax:718-228-7471
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0786491041C0700X
NY0803251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY078649OtherLICENSE #