Provider Demographics
NPI:1043678972
Name:SANTOS, JOSE ALBERTO (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:ALBERTO
Last Name:SANTOS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 BOGART AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4003
Mailing Address - Country:US
Mailing Address - Phone:929-314-3940
Mailing Address - Fax:
Practice Address - Street 1:1621 BOGART AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4003
Practice Address - Country:US
Practice Address - Phone:929-314-3940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-06
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099190-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker