Healthcare Provider Details

I. General information

NPI: 1205278132
Provider Name (Legal Business Name): CAROL M CHAPARRO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4487 3RD AVE 4TH FLOOR
BRONX NY
10457-1526
US

IV. Provider business mailing address

260 E 188TH ST 4TH FLOOR
BRONX NY
10458-5302
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-9000
  • Fax: 718-960-9159
Mailing address:
  • Phone: 718-960-3190
  • Fax: 718-933-8208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP90267
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: