Provider Demographics
NPI:1255865804
Name:FUTERNICK-GERAK, MEREDITH (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:FUTERNICK-GERAK
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 MORNING DEW CT
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1959
Mailing Address - Country:US
Mailing Address - Phone:718-431-5641
Mailing Address - Fax:
Practice Address - Street 1:171 MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3177
Practice Address - Country:US
Practice Address - Phone:718-431-5641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00818200101YM0800X
FLIMH 15293101YM0800X
VA0701010867101YM0800X
COLPC.0015659101YM0800X
MDLC12663101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health