Provider Demographics
NPI:1194946913
Name:CAREY, ROBERTA (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:CAREY
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 1:188-20C 69TH AVENUE
Mailing Address - Street 2:APT 1A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365
Mailing Address - Country:US
Mailing Address - Phone:718-454-1025
Mailing Address - Fax:
Practice Address - Street 1:330 WEST 58TH STREET
Practice Address - Street 2:SUITE 305
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-246-3806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO43328-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical