Provider Demographics
NPI:1447429204
Name:MEACHAM, ANN-MARIE SEMONE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANN-MARIE
Middle Name:SEMONE
Last Name:MEACHAM
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 1:271 STROBEL RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-3345
Mailing Address - Country:US
Mailing Address - Phone:203-606-7193
Mailing Address - Fax:
Practice Address - Street 1:2337 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3539
Practice Address - Country:US
Practice Address - Phone:203-606-7193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCTGA000525OtherDMHAS
CT004212148Medicaid