Doctor Name: | CLETUS A MEIERGERD |
NPI Number: | 1023142841 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 149006629 |
Business Practice Address: | 501 Ella Ave Joliet, IL - 604332799 |
Business Phone Number: | 8157278521 |
Business Fax Number: | |
Mailing Address: | 25029 S Foxford Dr, MANHATTAN |
State: | IL |
Postal Code: | 604429160 |
Phone Number: | 8154783282 |
Fax Number: | |
NPI Enumeration Date: | 03/15/2007 |
NPI Last Update Date: | 08/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149006629 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |