Provider Demographics
NPI:1104361583
Name:MEYER, CARRIE SUZANNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:SUZANNE
Last Name:MEYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5511 STAPLES MILL RD SUITE 300
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-9999
Mailing Address - Country:US
Mailing Address - Phone:804-230-0999
Mailing Address - Fax:
Practice Address - Street 1:8249 CROWN COLONY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-4057
Practice Address - Country:US
Practice Address - Phone:804-789-1224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040094871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1104361583Medicaid