Provider Demographics
NPI:1629115092
Name:DECARLO PRATOLA, CATHY (MSW)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:DECARLO PRATOLA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 N MAPLE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3247
Mailing Address - Country:US
Mailing Address - Phone:201-251-9555
Mailing Address - Fax:201-251-2949
Practice Address - Street 1:75 N MAPLE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3247
Practice Address - Country:US
Practice Address - Phone:201-251-9555
Practice Address - Fax:201-251-2949
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004854001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical