Provider Demographics
NPI:1992039945
Name:MERLIS, VANESSA N (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:N
Last Name:MERLIS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 W 23RD ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-1402
Mailing Address - Country:US
Mailing Address - Phone:917-685-1746
Mailing Address - Fax:212-691-1169
Practice Address - Street 1:435 W 23RD ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1402
Practice Address - Country:US
Practice Address - Phone:917-685-1746
Practice Address - Fax:212-691-1169
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR073510-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical