Provider Demographics
NPI:1134234586
Name:MERRIGAN, WALTER C (LCSW)
Entity type:Individual
Prefix:MR
First Name:WALTER
Middle Name:C
Last Name:MERRIGAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TATOMUCK RD
Mailing Address - Street 2:
Mailing Address - City:POUND RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10576-1431
Mailing Address - Country:US
Mailing Address - Phone:914-764-4920
Mailing Address - Fax:
Practice Address - Street 1:19 TATOMUCK RD
Practice Address - Street 2:
Practice Address - City:POUND RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10576-1431
Practice Address - Country:US
Practice Address - Phone:914-764-4920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSW 19636R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical