Provider Demographics
NPI:1952124117
Name:GONZALEZ, MEREDITH L (MA, LAPC)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:L
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MA, LAPC
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:L
Other - Last Name:ROUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LAPC
Mailing Address - Street 1:35 STONEY RUN RD APT 11
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-9338
Mailing Address - Country:US
Mailing Address - Phone:908-255-9628
Mailing Address - Fax:
Practice Address - Street 1:4225 GETTYSBURG RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-6630
Practice Address - Country:US
Practice Address - Phone:717-901-9552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000418101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health