Provider Demographics
NPI:1144490087
Name:LAYMAN, MEREDITH JO (LISW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:JO
Last Name:LAYMAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:JO
Other - Last Name:BRODIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3529
Mailing Address - Country:US
Mailing Address - Phone:419-999-2010
Mailing Address - Fax:419-999-6284
Practice Address - Street 1:2535 FORT AMANDA RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-3728
Practice Address - Country:US
Practice Address - Phone:419-999-2055
Practice Address - Fax:419-999-2058
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0222551041C0700X
OHI08000641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0362841Medicaid