Provider Demographics
NPI:1861261596
Name:ROUNTREE, CHARLENE C (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:C
Last Name:ROUNTREE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHARLENE
Other - Middle Name:
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:233 HOPPER ST
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-3809
Mailing Address - Country:US
Mailing Address - Phone:516-590-5544
Mailing Address - Fax:
Practice Address - Street 1:233 HOPPER ST
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-3809
Practice Address - Country:US
Practice Address - Phone:516-590-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
120243104100000X
NY120243104100000X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty