Individual
MR. CARLOS VICUNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
8956 162ND ST, JAMAICA, NY 11432-5072
(718) 657-7100
(718) 657-7137
Mailing address
3920 GREENPOINT AVE, APT. 7V, SUNNYSIDE, NY 11104-4532
(718) 937-5852
(718) 657-7137
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R058701
NY
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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