Healthcare Provider Details

I. General information

NPI: 1215984323
Provider Name (Legal Business Name): MEIER CLINICS OF MARYLAND, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N WASHINGTON ST STE 206
ROCKVILLE MD
20850-1778
US

IV. Provider business mailing address

2150 LAKESIDE BLVD STE 100
RICHARDSON TX
75082-4467
US

V. Phone/Fax

Practice location:
  • Phone: 301-315-9009
  • Fax: 301-315-2288
Mailing address:
  • Phone: 972-437-4698
  • Fax: 972-671-2087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904001984
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09709
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number303045
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number06169
License Number StateMD

VIII. Authorized Official

Name: HEATHER GANDY
Title or Position: NATIONAL DIRECTOR OF BUSINESS OP
Credential:
Phone: 630-653-1717