Provider Demographics
NPI:1952723413
Name:MARRERO, CARLOS (LMSW, EDD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:MARRERO
Suffix:
Gender:M
Credentials:LMSW, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-2730
Mailing Address - Country:US
Mailing Address - Phone:860-992-5569
Mailing Address - Fax:860-241-0327
Practice Address - Street 1:602 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-4033
Practice Address - Country:US
Practice Address - Phone:860-249-0975
Practice Address - Fax:833-968-2486
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-17
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool