Provider Demographics
NPI:1306535638
Name:LOIRA CARRERO, IRIS DOLORES (LCSW)
Entity type:Individual
Prefix:MRS
First Name:IRIS
Middle Name:DOLORES
Last Name:LOIRA CARRERO
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 1:2514 MACLAY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3004
Mailing Address - Country:US
Mailing Address - Phone:347-306-1139
Mailing Address - Fax:
Practice Address - Street 1:2514 MACLAY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3004
Practice Address - Country:US
Practice Address - Phone:347-306-1139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health