Provider Demographics
NPI:1811205909
Name:MCMEANS SPRUILL, MALIKA DIONNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MALIKA
Middle Name:DIONNE
Last Name:MCMEANS SPRUILL
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 1:917 SWEET HOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8652
Mailing Address - Country:US
Mailing Address - Phone:302-377-5883
Mailing Address - Fax:
Practice Address - Street 1:6 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9737
Practice Address - Country:US
Practice Address - Phone:302-377-5883
Practice Address - Fax:833-303-0292
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
620958001OtherMEDICARE DCN
DE100059400035Medicaid