Provider Demographics
NPI:1366860231
Name:PEACE, MEREDITH (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:PEACE
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:PO BOX 7152
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20898-7152
Mailing Address - Country:US
Mailing Address - Phone:240-777-4535
Mailing Address - Fax:240-777-4810
Practice Address - Street 1:1301 PICCARD DR
Practice Address - Street 2:1ST FLOOR
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4320
Practice Address - Country:US
Practice Address - Phone:240-777-4535
Practice Address - Fax:240-777-4810
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD058521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical