Provider Demographics
NPI:1578626255
Name:MEISELMAN, LORIE A (LCSW LPC)
Entity Type:Individual
Prefix:MS
First Name:LORIE
Middle Name:A
Last Name:MEISELMAN
Suffix:
Gender:F
Credentials:LCSW LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 NORTH AVE
Mailing Address - Street 2:23P
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024
Mailing Address - Country:US
Mailing Address - Phone:201-363-8840
Mailing Address - Fax:201-363-8748
Practice Address - Street 1:555 NORTH AVE
Practice Address - Street 2:23P
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024
Practice Address - Country:US
Practice Address - Phone:718-420-6958
Practice Address - Fax:201-363-8748
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0703971103T00000X
NJ37PC00227400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNX7641Medicare ID - Type Unspecified
NX7641Medicare UPIN