Provider Demographics
NPI:1629114988
Name:HAMRAH, MARIET J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIET
Middle Name:J
Last Name:HAMRAH
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 1:2452 STUART ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5816
Mailing Address - Country:US
Mailing Address - Phone:718-934-2313
Mailing Address - Fax:
Practice Address - Street 1:2452 STUART ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5816
Practice Address - Country:US
Practice Address - Phone:718-934-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR046745-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN9B111Medicare ID - Type Unspecified