Healthcare Provider Details

I. General information

NPI: 1215976790
Provider Name (Legal Business Name): CHARLENE E DONES LCSWR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3265 JOHNSON AVE STE 204
BRONX NY
10463-3539
US

IV. Provider business mailing address

PO BOX 1504
MONTICELLO NY
12701-8504
US

V. Phone/Fax

Practice location:
  • Phone: 570-404-5588
  • Fax:
Mailing address:
  • Phone: 914-564-5426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0732215-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: