Provider Demographics
NPI:1679288161
Name:MCLAURIN, MEREDITH ANNE (MA)
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:ANNE
Last Name:MCLAURIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 HALCYON LN STE 605
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-6692
Mailing Address - Country:US
Mailing Address - Phone:662-871-8666
Mailing Address - Fax:
Practice Address - Street 1:2950 HALCYON LN STE 605
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-6692
Practice Address - Country:US
Practice Address - Phone:662-871-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health