Provider Demographics
NPI:1972724409
Name:MEADERS, NOBUKO YOSHIZAWA (MSSW LCSW)
Entity type:Individual
Prefix:MRS
First Name:NOBUKO
Middle Name:YOSHIZAWA
Last Name:MEADERS
Suffix:
Gender:F
Credentials:MSSW LCSW
Other - Prefix:
Other - First Name:NOBUKO
Other - Middle Name:TSUCHIYA
Other - Last Name:MEADERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 EAST 10TH STREET
Mailing Address - Street 2:APT. # 3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-228-6988
Mailing Address - Fax:212-473-8271
Practice Address - Street 1:21 EAST 10TH STREET
Practice Address - Street 2:APT. # 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-228-6988
Practice Address - Fax:212-473-8271
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO 1442511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical