Healthcare Provider Details

I. General information

NPI: 1093282006
Provider Name (Legal Business Name): XIANGRU MENG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2018
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 ESSEX ST STE 303
HACKENSACK NJ
07601-8566
US

IV. Provider business mailing address

125 WALKER ST FL 2
NEW YORK NY
10013-4135
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-3091
  • Fax: 551-996-4806
Mailing address:
  • Phone: 212-226-8866
  • Fax: 212-226-2289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number093426
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06369200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: