Healthcare Provider Details

I. General information

NPI: 1679821847
Provider Name (Legal Business Name): MS. CAREN LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2012
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 BEACH 69TH ST
ARVERNE NY
11692-1346
US

IV. Provider business mailing address

16004 CROSSBAY BLVD # 206
HOWARD BEACH NY
11414-3407
US

V. Phone/Fax

Practice location:
  • Phone: 646-796-8964
  • Fax:
Mailing address:
  • Phone: 646-796-8964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06047700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number72 085647
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: