Provider Demographics
NPI:1568676567
Name:MEEHAN, MARIA M (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:M
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:D'AMICO
Other - Last Name:MEEHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:5 CHELSEA DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2734
Mailing Address - Country:US
Mailing Address - Phone:973-927-7751
Mailing Address - Fax:
Practice Address - Street 1:1240 SUSSEX TPKE
Practice Address - Street 2:SUITE 4
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2944
Practice Address - Country:US
Practice Address - Phone:973-895-1420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00303300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional