Provider Demographics
NPI:1306275052
Name:CARPENTIERE, ANN (LCSW)
Entity type:Individual
Prefix:MISS
First Name:ANN
Middle Name:
Last Name:CARPENTIERE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:CARPENTIERE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 6100
Mailing Address - Street 2:VETS MEMORIAL HIGHWAY, N. COUNTY COMPLEX, BUILDING C928
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-0099
Mailing Address - Country:US
Mailing Address - Phone:631-853-8510
Mailing Address - Fax:631-853-8518
Practice Address - Street 1:NORTH CP0UNTY COMPLEX, BUILDING C928
Practice Address - Street 2:VETS MEMORIAL HIGHWAY
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788
Practice Address - Country:US
Practice Address - Phone:631-853-8510
Practice Address - Fax:631-853-8518
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071028-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical