Provider Demographics
NPI:1568742534
Name:MEREOS, MARIA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MEREOS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 S FULLERTON AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2632
Mailing Address - Country:US
Mailing Address - Phone:973-744-6522
Mailing Address - Fax:
Practice Address - Street 1:60 S FULLERTON AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2632
Practice Address - Country:US
Practice Address - Phone:973-744-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00086200101Y00000X
NJ37PC00484900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor