Provider Demographics
NPI:1801346614
Name:REYES MERINO, ANDREA (LCSW - LMSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:REYES MERINO
Suffix:
Gender:F
Credentials:LCSW - LMSW
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:REYES MERINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:303 5TH AVE RM 1305
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6678
Mailing Address - Country:US
Mailing Address - Phone:646-895-5895
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE FL 13
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6601
Practice Address - Country:US
Practice Address - Phone:646-895-5895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0913281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical