Healthcare Provider Details

I. General information

NPI: 1356788319
Provider Name (Legal Business Name): TRISHA ANN MEYER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 GRANGER ST
RUTLAND VT
05701-4405
US

IV. Provider business mailing address

135 GRANGER ST
RUTLAND VT
05701-4405
US

V. Phone/Fax

Practice location:
  • Phone: 802-772-0700
  • Fax: 802-771-8009
Mailing address:
  • Phone: 802-772-0700
  • Fax: 802-771-8009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number089.0112323
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089.0112323
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: