Provider Demographics
NPI:1689700247
Name:ALBANESE, CAROL A (MSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:ALBANESE
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 1:1149 BLOOMFIELD AVENUE
Mailing Address - Street 2:CREATIVE INTERVENTION, LLC
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07112
Mailing Address - Country:US
Mailing Address - Phone:973-365-2300
Mailing Address - Fax:
Practice Address - Street 1:1149 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-2314
Practice Address - Country:US
Practice Address - Phone:973-365-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC008394001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical