Provider Demographics
NPI:1972050045
Name:MEYERS, KATIE (LCSW)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
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 1:18 ARBUTUS AVE
Mailing Address - Street 2:
Mailing Address - City:GRENLOCH
Mailing Address - State:NJ
Mailing Address - Zip Code:08032
Mailing Address - Country:US
Mailing Address - Phone:609-617-2091
Mailing Address - Fax:
Practice Address - Street 1:18 ARBUTUS AVE
Practice Address - Street 2:
Practice Address - City:GRENLOCH
Practice Address - State:NJ
Practice Address - Zip Code:08032
Practice Address - Country:US
Practice Address - Phone:609-617-2091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055099001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical