Healthcare Provider Details

I. General information

NPI: 1477633030
Provider Name (Legal Business Name): MEAGHAN ZERRLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEAGHAN DUNNE

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 10/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 DAYTON LN STE 205 ANDRUS CHILDRENS CENTER AT PEEKSKILL
PEEKSKILL NY
10566-2860
US

IV. Provider business mailing address

1156 N BROADWAY ANDRUS CHILDREN'S CENTER
YONKERS NY
10701-1108
US

V. Phone/Fax

Practice location:
  • Phone: 914-736-3371
  • Fax: 914-736-3372
Mailing address:
  • Phone: 914-965-3700
  • Fax: 914-965-3883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number077010
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1285628552
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerAGENCY NPI
# 2
Identifier077010
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerLCSW LICENSE
# 3
Identifier00355940
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerAGENCY MEDICAID #

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: