MEDICARE: CONSTANCE MESIARIK PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSO17232	PA

General Provider Information

NPI Number	:	1053254441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONSTANCE MESIARIK PHD

Provider Business Mailing Address
First Line	:	PO BOX 355
Second Line	:
City	:	POTTSTOWN
State	:	PA
Zip	:	19464-0355
Country	:	US
Telephone Number	:	484-431-0587
Fax Number	:

Provider Business Practice Location Address
First Line	:	1304 E HIGH ST STE 2
Second Line	:
City	:	POTTSTOWN
State	:	PA
Zip	:	19464-4958
Country	:	US
Telephone Number	:	610-776-9546
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2026
Last Update Date	:	04/11/2026

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