Provider Demographics
NPI:1740341825
Name:SALAZAR, CLAUDIA MARCELLA (LCSW)
Entity type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:MARCELLA
Last Name:SALAZAR
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 1:2510 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3512
Mailing Address - Country:US
Mailing Address - Phone:718-824-2792
Mailing Address - Fax:718-824-2793
Practice Address - Street 1:2510 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3512
Practice Address - Country:US
Practice Address - Phone:718-824-2792
Practice Address - Fax:718-824-2793
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NY074628-11041C0700X
NY077696-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113635418Medicaid