Provider Demographics
NPI:1629537089
Name:MCHUGH, MEREDITH (LCSW-C, PHD)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:
Last Name:MCHUGH
Suffix:
Gender:F
Credentials:LCSW-C, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 UNION AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1474
Mailing Address - Country:US
Mailing Address - Phone:443-552-5179
Mailing Address - Fax:
Practice Address - Street 1:1750 UNION AVE STE A1
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1474
Practice Address - Country:US
Practice Address - Phone:443-552-5179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24259104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD383841200Medicaid