Provider Demographics
NPI:1194744649
Name:MINTER-CARR, RENE (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:RENE
Middle Name:
Last Name:MINTER-CARR
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ROBINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-6519
Mailing Address - Country:US
Mailing Address - Phone:516-850-9062
Mailing Address - Fax:
Practice Address - Street 1:100 N VILLAGE AVE
Practice Address - Street 2:SUITE 39
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3767
Practice Address - Country:US
Practice Address - Phone:516-850-9062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR048412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health