Provider Demographics
NPI:1811988132
Name:MEYER, BAMBI L (LCSW, MSW)
Entity type:Individual
Prefix:
First Name:BAMBI
Middle Name:L
Last Name:MEYER
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:BAMBI
Other - Middle Name:L
Other - Last Name:ROWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, ACSW
Mailing Address - Street 1:30 W MONROE ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-2420
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:773-866-8014
Practice Address - Street 1:436 E WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-3210
Practice Address - Country:US
Practice Address - Phone:260-209-7111
Practice Address - Fax:260-222-2835
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005138A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical