Provider Demographics
NPI:1679915052
Name:SOUTHWELL, MEREDITH BOJARSKI (MSW)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:BOJARSKI
Last Name:SOUTHWELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 BOBBIEDELL LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5853
Mailing Address - Country:US
Mailing Address - Phone:804-727-9919
Mailing Address - Fax:
Practice Address - Street 1:1202 BOBBIEDELL LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5853
Practice Address - Country:US
Practice Address - Phone:804-727-9919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040098371041C0700X
NCC0097861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical