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NPI 1063181048

NPI 1063181048 : JOE MEADOR LCSW : NORFOLK, VA

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General NPI Number Information
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    NPI Number           |    1063181048
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    Entity Type          |    Individual 
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    Provider Name        |    JOE MEADOR LCSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/13/2021
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    Last Update Date     |    03/19/2025
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Provider Practice Location Address
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    Address Line         |    6330 NEWTOWN RD STE 300 
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    City                 |    NORFOLK
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    State                |    VA
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    Zip                  |    23502-4805
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    Country              |    US
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    Telephone            |    757-466-3336
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2202 EXECUTIVE DR STE C 
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    City                 |    HAMPTON
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    State                |    VA
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    Zip                  |    23666-6604
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    Country              |    US
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    Telephone            |    757-827-7707
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    0904013179
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    License Number State |    VA
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