Provider Demographics
NPI:1457334120
Name:CARLONI, ROSEMARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:
Last Name:CARLONI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ROSEMARIE
Other - Middle Name:
Other - Last Name:PAGAN-CARLONI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:679 48TH ST
Mailing Address - Street 2:APT. 2L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2153
Mailing Address - Country:US
Mailing Address - Phone:718-871-3439
Mailing Address - Fax:
Practice Address - Street 1:443 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2701
Practice Address - Country:US
Practice Address - Phone:917-435-0120
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR038937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNF6881Medicare ID - Type Unspecified