Provider Demographics
NPI:1417223405
Name:ACERRA, MARGARET L (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:L
Last Name:ACERRA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MARGARET
Other - Middle Name:L
Other - Last Name:ACERRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:10 LATTINGTOWN RIDGE CT
Mailing Address - Street 2:POBOX 503
Mailing Address - City:LOCUST VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11560-1302
Mailing Address - Country:US
Mailing Address - Phone:516-606-9299
Mailing Address - Fax:516-759-4029
Practice Address - Street 1:98120 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4357
Practice Address - Country:US
Practice Address - Phone:718-830-0846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-24
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020999-11041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist