Provider Demographics
NPI:1144367855
Name:HARDER, MARGUERITE MERLE (LCSW R)
Entity type:Individual
Prefix:MS
First Name:MARGUERITE
Middle Name:MERLE
Last Name:HARDER
Suffix:
Gender:F
Credentials:LCSW R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 LYNBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2156
Mailing Address - Country:US
Mailing Address - Phone:516-568-1816
Mailing Address - Fax:
Practice Address - Street 1:18410 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2400
Practice Address - Country:US
Practice Address - Phone:718-454-6940
Practice Address - Fax:718-264-3203
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR035834-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP80617Medicare UPIN
NY05421KMedicare ID - Type UnspecifiedGHI MEDICARE
NYN7T471Medicare ID - Type UnspecifiedEMPIRE MEDICARE