Provider Demographics
NPI:1871099226
Name:FERNANDEZ, MEIGAN (MA, LAC, NCC)
Entity type:Individual
Prefix:MS
First Name:MEIGAN
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MA, LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 TEHAMA ST
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2830
Mailing Address - Country:US
Mailing Address - Phone:908-472-6506
Mailing Address - Fax:
Practice Address - Street 1:4122 COUNTY RD 516
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-7031
Practice Address - Country:US
Practice Address - Phone:732-679-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty