Provider Demographics
NPI:1407211659
Name:MEYRING, VICTORIA (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:MEYRING
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:MCFAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:3901 BEAUBIEN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2119
Mailing Address - Country:US
Mailing Address - Phone:313-832-8497
Mailing Address - Fax:313-993-7106
Practice Address - Street 1:3901 BEAUBIEN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2119
Practice Address - Country:US
Practice Address - Phone:313-832-8497
Practice Address - Fax:313-993-7106
Is Sole Proprietor?:No
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010590741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical