Provider Demographics
NPI:1790924397
Name:MEYERS, MIRIAM (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:MIMI
Other - Middle Name:
Other - Last Name:MEYERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:121 STERLING PLACE
Mailing Address - Street 2:#4B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217
Mailing Address - Country:US
Mailing Address - Phone:718-622-7440
Mailing Address - Fax:
Practice Address - Street 1:245 E. 72ND STREET
Practice Address - Street 2:#1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11217
Practice Address - Country:US
Practice Address - Phone:212-861-6438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR014491-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical