Provider Demographics
NPI:1215980966
Name:HOROWITZ, CAROL E (LCSW)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:E
Last Name:HOROWITZ
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 1:24 WEST AVE
Mailing Address - Street 2:SUITE #306
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1344
Mailing Address - Country:US
Mailing Address - Phone:585-352-5450
Mailing Address - Fax:585-352-5460
Practice Address - Street 1:24 WEST AVE
Practice Address - Street 2:SUITE #306
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1344
Practice Address - Country:US
Practice Address - Phone:585-352-5450
Practice Address - Fax:585-352-5460
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0528821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0616Medicare ID - Type Unspecified