Provider Demographics
NPI:1194182261
Name:SHIREY, MEREDITH HOPE (LMFT)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:HOPE
Last Name:SHIREY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:HOPE
Other - Last Name:NARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:844 AMSTERDAM AVE
Mailing Address - Street 2:APT. 4N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5127
Mailing Address - Country:US
Mailing Address - Phone:929-244-3860
Mailing Address - Fax:
Practice Address - Street 1:42 BROADWAY
Practice Address - Street 2:SUITE 12-150
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1617
Practice Address - Country:US
Practice Address - Phone:929-844-3860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06001286106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06001286OtherMFT LICENSE NUMBER