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NPI Code Detail

MEDICARE: MEREDITH L VASA MA, LPC

MEDICARE: MEREDITH L VASA MA, LPC
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
1101YM0800XMental Health Counselor.0016886CO

General Provider Information

NPI Number : 1184217846
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEREDITH L VASA MA, LPC
Provider Business Mailing Address
First Line : 3515 E OVERLAND RD
Second Line :
City : MERIDIAN
State : ID
Zip : 83642-6757
Country : US
Telephone Number : 208-605-7070
Fax Number :
Provider Business Practice Location Address
First Line : 3800 AUTOMATION WAY STE 102
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-3451
Country : US
Telephone Number : 970-900-5835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2021
Last Update Date : 07/23/2024

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