Provider Demographics
NPI:1760897326
Name:ANFLICK, CHARLES (LCSW)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:ANFLICK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-2009
Mailing Address - Country:US
Mailing Address - Phone:718-681-8700
Mailing Address - Fax:646-367-1415
Practice Address - Street 1:1669 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-2009
Practice Address - Country:US
Practice Address - Phone:718-681-8700
Practice Address - Fax:646-367-1415
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086622-11041C0700X
NY076-154-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical