Provider Demographics
NPI:1922850171
Name:MERION HAWORTH LCSW LLC
Entity Type:Organization
Organization Name:MERION HAWORTH LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERION
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-270-9282
Mailing Address - Street 1:9219 RIVERBEND AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-5411
Mailing Address - Country:US
Mailing Address - Phone:505-270-9282
Mailing Address - Fax:
Practice Address - Street 1:9219 RIVERBEND AVE SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-5411
Practice Address - Country:US
Practice Address - Phone:505-270-9282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health