Provider Demographics
NPI:1710461918
Name:MEADOWS, ENDELEA (LCSW)
Entity Type:Individual
Prefix:
First Name:ENDELEA
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 HELLER PKWY # A2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-1635
Mailing Address - Country:US
Mailing Address - Phone:973-634-4381
Mailing Address - Fax:
Practice Address - Street 1:165 HELLER PKWY
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-1635
Practice Address - Country:US
Practice Address - Phone:201-371-3416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10959721041S0200X
NJ44SC062820001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool