MEDICARE: MARGO MEEKER L.C.S.W.

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	1041C0700X	Clinical Social Worker	004907	CT
2	1041C0700X	Clinical Social Worker	073282-1	NY

General Provider Information

NPI Number	:	1255570693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGO MEEKER L.C.S.W.

Provider Business Mailing Address
First Line	:	17 HARSTROM PL
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06853-1415
Country	:	US
Telephone Number	:	203-857-0261
Fax Number	:	203-857-4708

Provider Business Practice Location Address
First Line	:	17 HARSTROM PL
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06853-1415
Country	:	US
Telephone Number	:	203-857-0261
Fax Number	:	203-857-4708

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

Provider Enumeration Date	:	02/09/2009
Last Update Date	:	02/09/2009

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