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Individual
JUAN CARLOS ORTEGA
Active
Individual
JUAN CARLOS ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
069871
NY
1041C0700X
Clinical Social Worker
Primary
077392
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136167177
FIDELIS NUMBER
NY
Enumeration date
03/07/2007
Last updated
05/13/2024
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