MEDICARE: AMY MEEK MS, LCMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	225	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0007175383	OTHER	KS	AETNA
2	354397000	OTHER	KS	GREEN SPRING
3	318914	OTHER	KS	MANAGED HEALTH NETWORK
4	14146673	OTHER	KS	WAUSAU
5	2077333	OTHER	KS	CIGNA BEHAVIORAL HEALTH
6	383499	OTHER	KS	BCBS

General Provider Information

NPI Number	:	1144215278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY MEEK MS, LCMFT

Provider Business Mailing Address
First Line	:	345 RIVERVIEW ST
Second Line	:	SUITE LL2
City	:	WICHITA
State	:	KS
Zip	:	67203-4200
Country	:	US
Telephone Number	:	316-262-5253
Fax Number	:	316-262-7202

Provider Business Practice Location Address
First Line	:	606 MULBERRY RD
Second Line	:
City	:	DERBY
State	:	KS
Zip	:	67037-3532
Country	:	US
Telephone Number	:	316-788-4335
Fax Number	:	316-262-7202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	07/08/2007

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