Provider Demographics
NPI:1730450958
Name:BROWN-CAVALUZZO, MARJORIE (LMSW)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:BROWN-CAVALUZZO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1835 N. CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTH VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1835 N. CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580
Practice Address - Country:US
Practice Address - Phone:516-285-8310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060898-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool