Provider Demographics
NPI:1861520579
Name:EPSTEIN, MESHULEM MICHAEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:MESHULEM
Middle Name:MICHAEL
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1818
Mailing Address - Country:US
Mailing Address - Phone:570-343-7356
Mailing Address - Fax:
Practice Address - Street 1:1141 CLAY AVE
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18510-1191
Practice Address - Country:US
Practice Address - Phone:570-346-3686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0145021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA04491Q9ZMedicare ID - Type Unspecified
PAP23085Medicare UPIN