Basic Information
Provider Information
NPI: 1679627400
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAKKARAINEN
FirstName: MARCY
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 306 E 96TH ST APT 7A
Address2:  
City: NEW YORK
State: NY
PostalCode: 101283852
CountryCode: US
TelephoneNumber: 6466829142
FaxNumber:  
Practice Location
Address1: 348 13TH ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112155004
CountryCode: US
TelephoneNumber: 7187882461
FaxNumber: 7187888274
Other Information
ProviderEnumerationDate: 01/22/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X  Y Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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