Provider Demographics
NPI:1568707859
Name:O'BOYLE, MEREDITH ELLEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:ELLEN
Last Name:O'BOYLE
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 1:1751 PARK AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2831
Mailing Address - Country:US
Mailing Address - Phone:212-633-2500
Mailing Address - Fax:212-633-9232
Practice Address - Street 1:1751 PARK AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2831
Practice Address - Country:US
Practice Address - Phone:212-633-2500
Practice Address - Fax:212-633-9232
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0757001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical