Provider Demographics
NPI:1578257606
Name:DRAKE, MEREDITH ELLEN (LCMHCA)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ELLEN
Last Name:DRAKE
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 BALLENA CIR APT 1303
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4968
Mailing Address - Country:US
Mailing Address - Phone:919-303-0273
Mailing Address - Fax:
Practice Address - Street 1:950 WINDY RD STE 3058
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-2512
Practice Address - Country:US
Practice Address - Phone:919-303-0273
Practice Address - Fax:919-303-5986
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18799101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health