Provider Demographics
NPI:1962411694
Name:CARRERAS, DINA M (LMSW)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:M
Last Name:CARRERAS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 EMBOUGHT RD
Mailing Address - Street 2:
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-5312
Mailing Address - Country:US
Mailing Address - Phone:518-943-0574
Mailing Address - Fax:518-943-5396
Practice Address - Street 1:770 EMBOUGHT RD
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-5312
Practice Address - Country:US
Practice Address - Phone:518-943-0574
Practice Address - Fax:518-943-5396
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073312104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY073312OtherLMSW LICENSE NO