Healthcare Provider Details

I. General information

NPI: 1831014968
Provider Name (Legal Business Name): CLAIRE LYNN TETRO MSW, LMSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 BROADWAY STE 404
BROOKLYN NY
11211-6128
US

IV. Provider business mailing address

143 CENTRAL AVE APT 3R
BROOKLYN NY
11221-8551
US

V. Phone/Fax

Practice location:
  • Phone: 929-684-1969
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number127580
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: