Provider Demographics
NPI:1841316668
Name:CAROLE J. KOTLER,C.S.W.P.C.
Entity type:Organization
Organization Name:CAROLE J. KOTLER,C.S.W.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-938-8137
Mailing Address - Street 1:57 BLANCHE ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4621
Mailing Address - Country:US
Mailing Address - Phone:516-938-8137
Mailing Address - Fax:
Practice Address - Street 1:57 BLANCHE ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4621
Practice Address - Country:US
Practice Address - Phone:516-938-8137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR041475-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN9L501Medicare ID - Type Unspecified