Provider Demographics
NPI:1568616266
Name:MARRERO-DEYA, LYMARIS (MSW)
Entity Type:Individual
Prefix:MRS
First Name:LYMARIS
Middle Name:
Last Name:MARRERO-DEYA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 AMSTERDAM AVE APT 3S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5863
Mailing Address - Country:US
Mailing Address - Phone:917-497-0992
Mailing Address - Fax:
Practice Address - Street 1:424 AMSTERDAM AVE APT 3S
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5863
Practice Address - Country:US
Practice Address - Phone:917-497-0992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR91021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical