Provider Demographics
NPI:1730244278
Name:CINTRON-JIMENEZ, CELMIRA (LCSW-R)
Entity type:Individual
Prefix:
First Name:CELMIRA
Middle Name:
Last Name:CINTRON-JIMENEZ
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 NE 100TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2316
Mailing Address - Country:US
Mailing Address - Phone:917-734-2578
Mailing Address - Fax:
Practice Address - Street 1:936 HAVEMEYER AVE FL 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-1140
Practice Address - Country:US
Practice Address - Phone:917-600-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077358-11041C0700X
NY0737961041S0200X
NY077358-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NYG100000410Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331954Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY00695941Medicaid
NY331946Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331043Medicare Oscar/Certification