Provider Demographics
NPI:1881885259
Name:MARJORIE R. MAYER, LCSW
Entity type:Organization
Organization Name:MARJORIE R. MAYER, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-666-6909
Mailing Address - Street 1:208 HARRIS RD APT HA5
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-2118
Mailing Address - Country:US
Mailing Address - Phone:914-666-6909
Mailing Address - Fax:
Practice Address - Street 1:208 HARRIS RD APT HA5
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-2118
Practice Address - Country:US
Practice Address - Phone:914-666-6909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO33372-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty