Provider Demographics
NPI:1467073023
Name:ANSELL, MEREDITH (LMSW)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:ANSELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CLAREMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2903
Mailing Address - Country:US
Mailing Address - Phone:201-840-0265
Mailing Address - Fax:
Practice Address - Street 1:19 CLAREMOUNT AVE
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-2903
Practice Address - Country:US
Practice Address - Phone:201-840-0265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health