Provider Demographics
NPI:1821679796
Name:MEYER, JUSTINE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:
Last Name:MEYER
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 1:114 COLTON RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:CT
Mailing Address - Zip Code:06071-1532
Mailing Address - Country:US
Mailing Address - Phone:603-630-1184
Mailing Address - Fax:
Practice Address - Street 1:114 COLTON RD
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:CT
Practice Address - Zip Code:06071-1532
Practice Address - Country:US
Practice Address - Phone:603-630-1184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.0003285101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional