Provider Demographics
NPI:1265623797
Name:DECARO, LOUISE VERA (LCSW)
Entity type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:VERA
Last Name:DECARO
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 1:175 FULTON AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3718
Mailing Address - Country:US
Mailing Address - Phone:516-481-0052
Mailing Address - Fax:516-481-2115
Practice Address - Street 1:175 FULTON AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3718
Practice Address - Country:US
Practice Address - Phone:516-481-0052
Practice Address - Fax:516-481-2115
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0704151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical