Provider Demographics
NPI:1477579589
Name:HALLOWAY, MERA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MERA
Middle Name:
Last Name:HALLOWAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-1011
Mailing Address - Country:US
Mailing Address - Phone:914-737-4400
Mailing Address - Fax:914-788-4285
Practice Address - Street 1:24 SOUTH DR
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:12538-1011
Practice Address - Country:US
Practice Address - Phone:914-737-4400
Practice Address - Fax:914-788-4285
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070181-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical