Individual provider Active NPI

Merilee Joy Meacham, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1114147071
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11093 Issued in MD
Practice address
172 Thomas Johnson Dr
Suite 200
Frederick, MD 21702-4402
Phone
(301) 694-5896
Fax
(301) 662-8737
NPI assigned
Apr 25, 2007
Last updated
Oct 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11093 MD Primary

Addresses

Primary practice location

172 Thomas Johnson Dr
Suite 200
Frederick, MD 21702-4402

Mailing address

172 Thomas Johnson Dr
Suite 200
Frederick, MD 21702-4402
Phone (301) 694-5896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 26, 2017 through Jan 26, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11093MDMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1114147071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 THOMAS JOHNSON DR",
            "address_2": "SUITE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024402",
            "telephone_number": "301-694-5896",
            "fax_number": "301-662-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 THOMAS JOHNSON DR",
            "address_2": "SUITE 200",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024402",
            "telephone_number": "301-694-5896",
            "fax_number": "301-662-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEACHAM",
        "first_name": "MERILEE",
        "middle_name": "JOY",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.