Doctor Name: | CARA KEIDEL |
NPI Number: | 1356703425 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 092905 |
Business Practice Address: | 10819 Rockaway Blvd South Ozone Park, NY - 114201034 |
Business Phone Number: | 9175207809 |
Business Fax Number: | |
Mailing Address: | 487 Chauncey St, Apt 2r BROOKLYN |
State: | NY |
Postal Code: | 112332440 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/28/2016 |
NPI Last Update Date: | 03/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 092905 |
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 |