Provider Demographics
NPI:1114147071
Name:MEACHAM, MERILEE JOY (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MERILEE
Middle Name:JOY
Last Name:MEACHAM
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4402
Mailing Address - Country:US
Mailing Address - Phone:301-694-5896
Mailing Address - Fax:301-662-8737
Practice Address - Street 1:172 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4402
Practice Address - Country:US
Practice Address - Phone:301-694-5896
Practice Address - Fax:301-662-8737
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD110931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical