Provider Demographics
NPI:1831377571
Name:MEYER, MARY-BETH (LCSW)
Entity type:Individual
Prefix:
First Name:MARY-BETH
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3374 RELIEZ HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-1951
Mailing Address - Country:US
Mailing Address - Phone:925-212-4535
Mailing Address - Fax:925-287-1390
Practice Address - Street 1:1291 OAKLAND BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4359
Practice Address - Country:US
Practice Address - Phone:925-933-2627
Practice Address - Fax:925-933-5824
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA167231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical