Provider Demographics
NPI:1588804108
Name:NERIA, MARIANA JUDITH (LMSW)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:JUDITH
Last Name:NERIA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 VILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-1216
Mailing Address - Country:US
Mailing Address - Phone:914-479-5356
Mailing Address - Fax:
Practice Address - Street 1:450 SAINT PAULS PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-1938
Practice Address - Country:US
Practice Address - Phone:718-588-5305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-22
Last Update Date:2009-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069097-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker