Healthcare Provider Details

I. General information

NPI: 1205754579
Provider Name (Legal Business Name): AMANDA MEISTERLING LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 EASTERN BLVD
GLASTONBURY CT
06033-4321
US

IV. Provider business mailing address

38 JUNIPER ST
NEWINGTON CT
06111-2713
US

V. Phone/Fax

Practice location:
  • Phone: 860-815-8991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number12286
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: