Charles Joseph Bezousek, L.C.S.W

Individual provider Active NPI Clinical Social Worker · Carmel, NY

NPI 1710037403 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1710037403
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
R023891 (NY)
Practice address
36 Church Hill Rd
Carmel, NY 10512-3043
Phone
(845) 225-0052
Fax
(845) 225-0052
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R023891NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R023891 NY Yes

Addresses

Primary practice location

36 Church Hill Rd
Carmel, NY 10512-3043

Mailing address

36 Church Hill Rd
Carmel, NY 10512-3043
Phone (845) 225-0052

Other providers in Carmel, NY

All providers in Carmel, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.