Healthcare Provider Details

I. General information

NPI: 1699725135
Provider Name (Legal Business Name): MERYLE KREUTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 COMMERCE ST STE 5B
YORKTOWN HEIGHTS NY
10598-4435
US

IV. Provider business mailing address

PO BOX 333
YORKTOWN HEIGHTS NY
10598-0333
US

V. Phone/Fax

Practice location:
  • Phone: 914-584-3287
  • Fax: 914-455-8055
Mailing address:
  • Phone: 914-584-3287
  • Fax: 914-455-8055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072786
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: