Provider Demographics
NPI:1134666399
Name:MENG, TAO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:TAO
Middle Name:
Last Name:MENG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:COLIN
Other - Middle Name:TAO
Other - Last Name:MENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:6720 HILLPARK DR APT 201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-2114
Mailing Address - Country:US
Mailing Address - Phone:310-435-8690
Mailing Address - Fax:
Practice Address - Street 1:6720 HILLPARK DR APT 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-2114
Practice Address - Country:US
Practice Address - Phone:310-435-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW717731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical