Doctor Name: | MS. LOIS MERGENTIME |
NPI Number: | 1124035852 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | PR024991-1 |
Business Practice Address: | 271 S Broadway Nyack, NY - 109604636 |
Business Phone Number: | 8456419595 |
Business Fax Number: | 8452672173 |
Mailing Address: | 272 Piermont Ave, NYACK |
State: | NY |
Postal Code: | 109604663 |
Phone Number: | 8453530890 |
Fax Number: | 8452672173 |
NPI Enumeration Date: | 08/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | PR024991-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |