Provider Demographics
NPI:1932137874
Name:BRIENDEL, CAROL (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BRIENDEL
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 1:119 BIRCHWOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2239
Mailing Address - Country:US
Mailing Address - Phone:347-733-2899
Mailing Address - Fax:
Practice Address - Street 1:189 MONTAGUE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3610
Practice Address - Country:US
Practice Address - Phone:718-596-9979
Practice Address - Fax:718-522-9970
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0276781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN0A461Medicare ID - Type Unspecified