Provider Demographics
NPI:1356788319
Name:MEYER, TRISHA ANN (LICSW)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANN
Last Name:MEYER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 GRANGER ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4405
Mailing Address - Country:US
Mailing Address - Phone:802-772-0700
Mailing Address - Fax:802-771-8009
Practice Address - Street 1:135 GRANGER ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4405
Practice Address - Country:US
Practice Address - Phone:802-772-0700
Practice Address - Fax:802-771-8009
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.0112323104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker