Provider Demographics
NPI:1588436356
Name:MERA, CARLOTA MONICA (SCHOOL PSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:CARLOTA
Middle Name:MONICA
Last Name:MERA
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 STADIUM AVE APT 2G
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1533
Mailing Address - Country:US
Mailing Address - Phone:860-216-8736
Mailing Address - Fax:
Practice Address - Street 1:2465 BATHGATE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5928
Practice Address - Country:US
Practice Address - Phone:718-367-5917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349605103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool