Provider Demographics
NPI:1790383297
Name:DENG, CAROL (LMSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:DENG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:DENG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2480 CROPSEY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6624
Mailing Address - Country:US
Mailing Address - Phone:917-225-1555
Mailing Address - Fax:
Practice Address - Street 1:2480 CROPSEY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6624
Practice Address - Country:US
Practice Address - Phone:917-225-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10871001104100000X
NY0955161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY095516Medicaid