Provider Demographics
NPI:1942454657
Name:FADEN, CURT (LCSW-R ACSW)
Entity Type:Individual
Prefix:MR
First Name:CURT
Middle Name:
Last Name:FADEN
Suffix:
Gender:M
Credentials:LCSW-R ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16210 POWELLS COVE BLVD
Mailing Address - Street 2:APT 8-B
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1446
Mailing Address - Country:US
Mailing Address - Phone:646-591-2931
Mailing Address - Fax:
Practice Address - Street 1:16210 POWELLS COVE BLVD
Practice Address - Street 2:APT 8-B
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1446
Practice Address - Country:US
Practice Address - Phone:646-591-2931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR040288-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker