Provider Demographics
NPI:1922327071
Name:VERDI, CAROL ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL ANN
Middle Name:
Last Name:VERDI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16230 CROSSBAY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3443
Mailing Address - Country:US
Mailing Address - Phone:718-323-2877
Mailing Address - Fax:718-323-2897
Practice Address - Street 1:16230 CROSSBAY BLVD
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-3443
Practice Address - Country:US
Practice Address - Phone:718-323-2877
Practice Address - Fax:718-323-2897
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR029253-11041C0700X
NY3410499011041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool