Provider Demographics
NPI:1780844761
Name:MERA, MARIA SUSANA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:SUSANA
Last Name:MERA
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 1:2527 GLEBE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3109
Mailing Address - Country:US
Mailing Address - Phone:718-904-4400
Mailing Address - Fax:718-931-7307
Practice Address - Street 1:1967 TURNBULL AVE
Practice Address - Street 2:SUITE 26
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2519
Practice Address - Country:US
Practice Address - Phone:718-842-1400
Practice Address - Fax:718-328-3349
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073401-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical