Healthcare Provider Details

I. General information

NPI: 1265964365
Provider Name (Legal Business Name): JUANITA ANN MEADLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 SOMERSET J
WEST PALM BEACH FL
33417-2129
US

IV. Provider business mailing address

188 SOMERSET J
WEST PALM BEACH FL
33417-2129
US

V. Phone/Fax

Practice location:
  • Phone: 561-983-3552
  • Fax:
Mailing address:
  • Phone: 561-983-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW11836
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: