Provider Demographics
NPI:1679734073
Name:NEARY, MICHELLE CATHERINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:CATHERINE
Last Name:NEARY
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 1:170 BROADWAY
Mailing Address - Street 2:SVCMC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4154
Mailing Address - Country:US
Mailing Address - Phone:212-346-2582
Mailing Address - Fax:
Practice Address - Street 1:170 BROADWAY
Practice Address - Street 2:SVCMC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4154
Practice Address - Country:US
Practice Address - Phone:212-346-2582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070082-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical