Provider Demographics
NPI:1356788319
Name:MEYER, TRISHA ANN (LCSW-P)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANN
Last Name:MEYER
Suffix:
Gender:F
Credentials:LCSW-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 S DEKALB ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-6182
Mailing Address - Country:US
Mailing Address - Phone:704-482-2460
Mailing Address - Fax:704-487-5950
Practice Address - Street 1:824 S DEKALB ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-6182
Practice Address - Country:US
Practice Address - Phone:704-482-2460
Practice Address - Fax:704-487-5950
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0080911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical