Provider Demographics
NPI:1649503756
Name:PINKHAM, MEREDITH ANN (LCSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ANN
Last Name:PINKHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:ANN
Other - Last Name:MCEWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 HORTON PL
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1747
Mailing Address - Country:US
Mailing Address - Phone:207-798-6200
Mailing Address - Fax:207-798-6290
Practice Address - Street 1:4 HORTON PL
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1747
Practice Address - Country:US
Practice Address - Phone:207-798-6200
Practice Address - Fax:207-798-6290
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC127351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical