Healthcare Provider Details

I. General information

NPI: 1265623797
Provider Name (Legal Business Name): LOUISE VERA DECARO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 FULTON AVE SUITE 206
HEMPSTEAD NY
11550-3718
US

IV. Provider business mailing address

175 FULTON AVE SUITE 206
HEMPSTEAD NY
11550-3718
US

V. Phone/Fax

Practice location:
  • Phone: 516-481-0052
  • Fax: 516-481-2115
Mailing address:
  • Phone: 516-481-0052
  • Fax: 516-481-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number070415
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: