Individual
CAROL J DEACON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
110 GREENE ST, SUITE 504, NEW YORK, NY 10012-3813
(212) 966-5155
Mailing address
192 SPRING ST, APT. 5, NEW YORK, NY 10012-5600
(212) 226-4618
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P064089-2
NY
Other
Enumeration date
04/02/2006
Last updated
07/08/2007
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