MEDICARE: KATELYNN MEJIA LSW

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	101YM0800X	Mental Health Counselor	44SL07364400	NJ

General Provider Information

NPI Number	:	1891643458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYNN MEJIA LSW

Provider Business Mailing Address
First Line	:	100 MARKET ST FL 2
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07012-2405
Country	:	US
Telephone Number	:	201-431-2340
Fax Number	:

Provider Business Practice Location Address
First Line	:	1980 WOODBRIDGE AVE
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-4452
Country	:	US
Telephone Number	:	908-267-4605
Fax Number	:

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

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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