Healthcare Provider Details

I. General information

NPI: 1386889319
Provider Name (Legal Business Name): CATHERINE MEQUIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE MINEWISER LCSW

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 12/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1983 MARCUS AVE STE E100
NEW HYDE PARK NY
11042-1029
US

IV. Provider business mailing address

1983 MARCUS AVE STE E100
NEW HYDE PARK NY
11042-1029
US

V. Phone/Fax

Practice location:
  • Phone: 516-326-5642
  • Fax: 516-326-5676
Mailing address:
  • Phone: 516-326-5642
  • Fax: 516-326-5676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number075285-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1041CO700X
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: