Provider Demographics
NPI:1073813903
Name:ALTER, MARC (LCSW)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:ALTER
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 1:225 E 5TH ST
Mailing Address - Street 2:4AR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-8534
Mailing Address - Country:US
Mailing Address - Phone:646-345-9068
Mailing Address - Fax:
Practice Address - Street 1:6405 BLVD EAST
Practice Address - Street 2:C4
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-4121
Practice Address - Country:US
Practice Address - Phone:646-345-9068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0775471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical