Provider Demographics
NPI:1881848166
Name:MERS, STEPHANIE R (LMFT, LMSW)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:R
Last Name:MERS
Suffix:
Gender:F
Credentials:LMFT, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CROOKED HILL RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3811
Mailing Address - Country:US
Mailing Address - Phone:631-385-1373
Mailing Address - Fax:
Practice Address - Street 1:755 NEW YORK AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4240
Practice Address - Country:US
Practice Address - Phone:631-626-1821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033509-1104100000X
NY000452106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker