Provider Demographics
NPI:1174746945
Name:MEREL, STACEY J (LCSW)
Entity type:Individual
Prefix:MS
First Name:STACEY
Middle Name:J
Last Name:MEREL
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 1:215 W 88TH ST
Mailing Address - Street 2:APT. 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2321
Mailing Address - Country:US
Mailing Address - Phone:212-595-9817
Mailing Address - Fax:
Practice Address - Street 1:155 RIVERSIDE DR
Practice Address - Street 2:APT. 12C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2219
Practice Address - Country:US
Practice Address - Phone:212-595-9817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR026713-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical