Provider Demographics
NPI:1528494895
Name:ROOP, MARJORIE (LCSW)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:ROOP
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:164 W. 80TH ST.
Mailing Address - Street 2:COGNITIVE HEALTH GROUP
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:917-562-7897
Mailing Address - Fax:
Practice Address - Street 1:164 W 80TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6357
Practice Address - Country:US
Practice Address - Phone:917-562-7897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0741471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical