Provider Demographics
NPI:1487082103
Name:HEGEDUS, MEREDITH MERTENS
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MERTENS
Last Name:HEGEDUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MAITLAND ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3923
Mailing Address - Country:US
Mailing Address - Phone:443-356-6828
Mailing Address - Fax:
Practice Address - Street 1:314 MAITLAND ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3923
Practice Address - Country:US
Practice Address - Phone:443-356-6828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-15
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional