Provider Demographics
NPI:1922525757
Name:CAWLEY, RICHARD (LCSW, CASAC 2)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:CAWLEY
Suffix:
Gender:M
Credentials:LCSW, CASAC 2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 STATION PLZ N STE 350A
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3814
Mailing Address - Country:US
Mailing Address - Phone:516-663-2691
Mailing Address - Fax:516-566-3842
Practice Address - Street 1:222 STATION PLZ N STE 350A
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3814
Practice Address - Country:US
Practice Address - Phone:516-663-2691
Practice Address - Fax:516-663-8422
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33672101YA0400X
NY100967104100000X
NY0923741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01420795Medicaid