Provider Demographics
NPI:1316971914
Name:MEYERS, TRACIE (MSW)
Entity type:Individual
Prefix:MS
First Name:TRACIE
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:TRACIE
Other - Middle Name:RENEE
Other - Last Name:GRIMSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:100 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304
Mailing Address - Country:US
Mailing Address - Phone:201-450-2522
Mailing Address - Fax:
Practice Address - Street 1:492 COMMUNIPAW AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2939
Practice Address - Country:US
Practice Address - Phone:800-994-6242
Practice Address - Fax:800-994-6242
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054403001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical