Provider Demographics
NPI:1144873381
Name:CALIXTE, CLEON (LMSW)
Entity type:Individual
Prefix:
First Name:CLEON
Middle Name:
Last Name:CALIXTE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8722 PITKIN AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-1901
Mailing Address - Country:US
Mailing Address - Phone:917-817-3415
Mailing Address - Fax:
Practice Address - Street 1:8722 PITKIN AVE APT 3B
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-1901
Practice Address - Country:US
Practice Address - Phone:917-817-3415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105420-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical