Provider Demographics
NPI:1003071911
Name:BEER, HOLLACE MERRILL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:HOLLACE
Middle Name:MERRILL
Last Name:BEER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 GRISSOM AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4908
Mailing Address - Country:US
Mailing Address - Phone:718-698-6903
Mailing Address - Fax:
Practice Address - Street 1:23 GRISSOM AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4908
Practice Address - Country:US
Practice Address - Phone:718-698-6903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0258261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical