Provider Demographics
NPI:1619174935
Name:FUENTES, FRANK RAMON (LMSW)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:RAMON
Last Name:FUENTES
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 1:411 PEARL ST # 137B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1432
Mailing Address - Country:US
Mailing Address - Phone:212-964-9610
Mailing Address - Fax:212-732-6622
Practice Address - Street 1:411 PEARL ST # 137B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1432
Practice Address - Country:US
Practice Address - Phone:212-964-9610
Practice Address - Fax:212-732-6622
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069924104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker