Provider Demographics
NPI:1477856102
Name:LLERAS, NATALIE MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:MARIE
Last Name:LLERAS
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 1:3909 233RD ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1543
Mailing Address - Country:US
Mailing Address - Phone:561-880-2847
Mailing Address - Fax:
Practice Address - Street 1:1847 MOTT AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4201
Practice Address - Country:US
Practice Address - Phone:516-880-2847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0815911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical