Provider Demographics
NPI:1366971004
Name:CONSULTING CARE LCSW, PLLC
Entity type:Organization
Organization Name:CONSULTING CARE LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANDELARIO-CARMONA
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-708-9777
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-0521
Mailing Address - Country:US
Mailing Address - Phone:917-708-9777
Mailing Address - Fax:
Practice Address - Street 1:912 PELHAM PKWY S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-1102
Practice Address - Country:US
Practice Address - Phone:917-708-9777
Practice Address - Fax:866-274-4236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY039590620Medicaid