Provider Demographics
NPI:1760971956
Name:BERNICE, MEAGHAN (LPC)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:BERNICE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 NANCY LN
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2523
Mailing Address - Country:US
Mailing Address - Phone:201-527-0445
Mailing Address - Fax:
Practice Address - Street 1:110 WARREN AVE STE 6
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1561
Practice Address - Country:US
Practice Address - Phone:201-857-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00419000101Y00000X
NJ37PC00755800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor