Provider Demographics
NPI:1639607500
Name:LOIACONO MERVES, MARNI L (LCSW)
Entity Type:Individual
Prefix:
First Name:MARNI
Middle Name:L
Last Name:LOIACONO MERVES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARNI
Other - Middle Name:L
Other - Last Name:LOIACONO MERVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:225 STANLEY AVE UNIT 217
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-2578
Mailing Address - Country:US
Mailing Address - Phone:914-835-3160
Mailing Address - Fax:
Practice Address - Street 1:910 E BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543
Practice Address - Country:US
Practice Address - Phone:914-595-6538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0853461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical