Doctor Name: | ALAN FUENTES |
NPI Number: | 1194970608 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW-R |
License Number: | R054103 |
Business Practice Address: | 27 Liberty Square Stony Point, NY - 10980 |
Business Phone Number: | 8454296900 |
Business Fax Number: | 8454297050 |
Mailing Address: | 27 Liberty Square, STONY POINT |
State: | NY |
Postal Code: | 10980 |
Phone Number: | 8454296900 |
Fax Number: | 8454297050 |
NPI Enumeration Date: | 11/25/2008 |
NPI Last Update Date: | 11/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R054103 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |