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General NPI Number Information
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NPI Number | 1376645028
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Entity Type | Individual
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Provider Name | MEREDITH ELLEN MAISLEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 611 SW HURBERT STREET STE A
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City | NEWPORT
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State | OR
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Zip | 97365-4715
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Country | US
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Telephone | 541-265-3573
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1305
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City | NEWPORT
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State | OR
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Zip | 97365-0101
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Country | US
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Telephone | 541-265-3573
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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 | LCS13678
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 021280-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW 0690
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License Number State | OR
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