Provider Demographics
NPI:1861814055
Name:MEADOR, JUSTINE (MSW)
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:MEADOR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 CAMINO DEL REMEDIO SUITE B
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110
Mailing Address - Country:US
Mailing Address - Phone:805-884-6850
Mailing Address - Fax:
Practice Address - Street 1:315 CAMINO DEL REMEDIO SUITE B
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-3814
Practice Address - Country:US
Practice Address - Phone:805-884-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-08
Last Update Date:2023-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA956141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health