Provider Demographics
NPI:1093886152
Name:CLARY, MEGAN JENNIFER (PHD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:JENNIFER
Last Name:CLARY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 CLINTON AVE
Mailing Address - Street 2:#10H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1176
Mailing Address - Country:US
Mailing Address - Phone:917-923-2388
Mailing Address - Fax:
Practice Address - Street 1:32 COURT ST
Practice Address - Street 2:9TH FLOOR SUITE 904
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4404
Practice Address - Country:US
Practice Address - Phone:212-802-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016413103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical