Provider Demographics
NPI:1477969103
Name:MESZAROS, DESIREE (MSED, LMHC, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:
Last Name:MESZAROS
Suffix:
Gender:F
Credentials:MSED, LMHC, LPC, NCC
Other - Prefix:MS
Other - First Name:DESIREE
Other - Middle Name:
Other - Last Name:GULLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:372 CONOVER ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-1206
Mailing Address - Country:US
Mailing Address - Phone:917-691-9442
Mailing Address - Fax:
Practice Address - Street 1:585 79TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3709
Practice Address - Country:US
Practice Address - Phone:917-691-9442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006147101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health