Provider Demographics
NPI:1114052842
Name:MEISEL, TOBIE (JD,LCSW)
Entity Type:Individual
Prefix:
First Name:TOBIE
Middle Name:
Last Name:MEISEL
Suffix:
Gender:F
Credentials:JD,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-3516
Mailing Address - Country:US
Mailing Address - Phone:201-337-9166
Mailing Address - Fax:
Practice Address - Street 1:55 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-3516
Practice Address - Country:US
Practice Address - Phone:201-337-9166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO47763001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22-3239575OtherTAX ID