Provider Demographics
NPI:1528463841
Name:WILSON, MEREDITH TURNBULL (LCSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:TURNBULL
Last Name:WILSON
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 1:241 AUDREY CIR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-8671
Mailing Address - Country:US
Mailing Address - Phone:919-272-4181
Mailing Address - Fax:
Practice Address - Street 1:10010 PLATTE XING
Practice Address - Street 2:APT 103
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-9300
Practice Address - Country:US
Practice Address - Phone:919-272-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0083541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical