Provider Demographics
NPI:1003203530
Name:GAROFALO, MEREDITH (LPC)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:GAROFALO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2339 CHESTERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205
Mailing Address - Country:US
Mailing Address - Phone:773-263-6765
Mailing Address - Fax:
Practice Address - Street 1:2339 CHESTERFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6017
Practice Address - Country:US
Practice Address - Phone:773-263-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12981101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional