MEDICARE: ROSE CARPENZANO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	085034-1	NY
2	1041C0700X	Clinical Social Worker	11032	SC
3	1041C0700X	Clinical Social Worker	093662	NY

General Provider Information

NPI Number	:	1326393745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE CARPENZANO LCSW

Provider Business Mailing Address
First Line	:	165 N VILLAGE AVE STE 12
Second Line	:
City	:	ROCKVILLE CENTRE
State	:	NY
Zip	:	11570-3701
Country	:	US
Telephone Number	:	516-350-8564
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 GROVE AVE STE 216
Second Line	:
City	:	CEDARHURST
State	:	NY
Zip	:	11516-2302
Country	:	US
Telephone Number	:	516-350-8564
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2012
Last Update Date	:	11/20/2023

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Directions to “ ROSE CARPENZANO LCSW” Practice Location

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