Provider Demographics
NPI:1235552050
Name:MCCLAIN, MEREDITH A (LCSW)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:A
Last Name:MCCLAIN
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 1:6 ENTERPRISE CT
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-4112
Mailing Address - Country:US
Mailing Address - Phone:856-975-0017
Mailing Address - Fax:
Practice Address - Street 1:6 ENTERPRISE CT
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-4112
Practice Address - Country:US
Practice Address - Phone:856-975-0017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055618001041C0700X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical