Provider Demographics
NPI:1972225357
Name:MENEZES, MERYL
Entity type:Individual
Prefix:
First Name:MERYL
Middle Name:
Last Name:MENEZES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 RUPERT ST
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5450
Mailing Address - Country:US
Mailing Address - Phone:571-282-9866
Mailing Address - Fax:
Practice Address - Street 1:8000 TOWERS CRESCENT DR FL 13
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-6211
Practice Address - Country:US
Practice Address - Phone:240-219-8615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0903003917104100000X
NY117562104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker