Provider Demographics
NPI:1336201151
Name:CARLTON, DENIS C (MA MSW DCSW)
Entity Type:Individual
Prefix:MR
First Name:DENIS
Middle Name:C
Last Name:CARLTON
Suffix:
Gender:M
Credentials:MA MSW DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 YORKTOWN STREET
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5134
Mailing Address - Country:US
Mailing Address - Phone:516-536-2459
Mailing Address - Fax:
Practice Address - Street 1:60 YORKTOWN STREET
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5134
Practice Address - Country:US
Practice Address - Phone:516-536-2459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02417111041C0700X
106H00000X
NY1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
N19432Medicare ID - Type Unspecified