Provider Demographics
NPI:1891851481
Name:CARRON, WILLIAM JOSEPH (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:CARRON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:WILLIAM
Other - Middle Name:JOSEPH
Other - Last Name:CARRON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4730 59TH ST
Mailing Address - Street 2:APT. 14K
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-5547
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4730 59TH ST
Practice Address - Street 2:APT. 14K
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-5547
Practice Address - Country:US
Practice Address - Phone:347-531-4946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR020566-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health