Provider Demographics
NPI:1386884815
Name:WAKELYN, MEREDITH ELIZABETH (LCSW)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:ELIZABETH
Last Name:WAKELYN
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 1:1855 S PEARL ST
Mailing Address - Street 2:SUITE #20
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3161
Mailing Address - Country:US
Mailing Address - Phone:720-371-1882
Mailing Address - Fax:
Practice Address - Street 1:1855 S PEARL ST
Practice Address - Street 2:SUITE #20
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3161
Practice Address - Country:US
Practice Address - Phone:720-371-1882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9919391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical