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General NPI Number Information
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NPI Number | 1972609915
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Entity Type | Individual
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Provider Name | DAVID MARK MEYERS LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1090 MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-3716
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Country | US
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Telephone | 203-260-0647
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Fax | 203-315-1557
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Provider Business Mailing Address
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Address Line | 1090 MAIN ST PO BIX 567
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City | BRANFORD
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State | CT
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Zip | 06405-3716
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Country | US
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Telephone | 203-260-0647
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Fax | 203-315-1557
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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 | 005177
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License Number State | CT
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