Provider Demographics
NPI:1912083080
Name:MEYERS, SANDRA JUDITH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:JUDITH
Last Name:MEYERS
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 1:204 SOUNDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-3824
Mailing Address - Country:US
Mailing Address - Phone:914-993-9035
Mailing Address - Fax:
Practice Address - Street 1:204 SOUNDVIEW AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-3824
Practice Address - Country:US
Practice Address - Phone:914-993-9035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR002092-1171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator