Provider Demographics
NPI:1679002265
Name:CARIAS, GUAROA MIGUEL (LMSW)
Entity Type:Individual
Prefix:
First Name:GUAROA
Middle Name:MIGUEL
Last Name:CARIAS
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 1:91 GUY LOMBARDO AVENUE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520
Mailing Address - Country:US
Mailing Address - Phone:516-868-3030
Mailing Address - Fax:516-868-3374
Practice Address - Street 1:91 GUY LOMBARDO AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3731
Practice Address - Country:US
Practice Address - Phone:516-868-3030
Practice Address - Fax:516-868-3374
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000998661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical