Provider Demographics
NPI:1497202261
Name:GREELEY, MEAGHAN (LCSW)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:GREELEY
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 1:229 KENSINGTON PL
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-3307
Mailing Address - Country:US
Mailing Address - Phone:315-430-6047
Mailing Address - Fax:
Practice Address - Street 1:229 KENSINGTON PL
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-3307
Practice Address - Country:US
Practice Address - Phone:315-430-6047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090523101Y00000X
NY090523011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor