Provider Demographics
NPI:1669950267
Name:MEYER, MARLA P (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:P
Last Name:MEYER
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-0249
Mailing Address - Country:US
Mailing Address - Phone:781-576-0860
Mailing Address - Fax:
Practice Address - Street 1:237 WASHINGTON ST FL 2
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-3334
Practice Address - Country:US
Practice Address - Phone:781-576-0860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1210741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical