Provider Demographics
NPI:1386884088
Name:PETGRAVE, CAROLINE (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:
Last Name:PETGRAVE
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 1:27 BARROW ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-3823
Mailing Address - Country:US
Mailing Address - Phone:917-817-0396
Mailing Address - Fax:
Practice Address - Street 1:27 BARROW ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-3823
Practice Address - Country:US
Practice Address - Phone:212-242-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
NY0823501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical