Carol Ann Assenza, LCSW

Individual provider Active NPI Clinical Social Worker · Deer Park, NY

NPI 1720200868 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1720200868
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
072169-1 (NY)
Practice address
348 W 23Rd St
Deer Park, NY 11729-6331
Phone
(631) 243-5180
Fax
(631) 370-1886
NPI assigned
May 2, 2007
Sex
Female
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
072169-1NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 072169-1 NY Yes

Addresses

Primary practice location

348 W 23Rd St
Deer Park, NY 11729-6331

Mailing address

348 W 23Rd St
Deer Park, NY 11729-6331
Phone (631) 243-5180

Other providers in Deer Park, NY

All providers in Deer Park, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.