Provider Demographics
NPI:1215477120
Name:MEADOWS-EFRAM, CORINNE (LMFT, PPSC)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:MEADOWS-EFRAM
Suffix:
Gender:F
Credentials:LMFT, PPSC
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:
Other - Last Name:MEADOWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:825 UNIVERSITY ST
Mailing Address - Street 2:
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3748
Mailing Address - Country:US
Mailing Address - Phone:707-490-2504
Mailing Address - Fax:
Practice Address - Street 1:825 UNIVERSITY ST
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3748
Practice Address - Country:US
Practice Address - Phone:707-490-2504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YS0200X
CALMFT37617106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool