Healthcare Provider Details

I. General information

NPI: 1639841638
Provider Name (Legal Business Name): JOYCE MEIKLEJOHN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 LEXINGTON AVE
MOUNT KISCO NY
10549-4307
US

IV. Provider business mailing address

491 LEXINGTON AVE
MOUNT KISCO NY
10549-4307
US

V. Phone/Fax

Practice location:
  • Phone: 914-312-1346
  • Fax:
Mailing address:
  • Phone: 914-312-1346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number090096
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: