MEDICARE: MS. LORI LYNN MEADER 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	R052932-1	NY

General Provider Information

NPI Number	:	1346712395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORI LYNN MEADER L.C.S.W.

Provider Business Mailing Address
First Line	:	152 MADISON AVENUE
Second Line	:	SUITE 1000
City	:	NEW YORK
State	:	NY
Zip	:	10016-5472
Country	:	US
Telephone Number	:	212-532-3733
Fax Number	:

Provider Business Practice Location Address
First Line	:	152 MADISON AVENUE
Second Line	:	SUITE 1000
City	:	NEW YORK
State	:	NY
Zip	:	10016-5472
Country	:	US
Telephone Number	:	212-532-3733
Fax Number	:

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

Provider Enumeration Date	:	12/31/2018
Last Update Date	:	12/31/2018

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