Healthcare Provider Details

I. General information

NPI: 1831482819
Provider Name (Legal Business Name): LAURA S. MCMEEKIN BA, CACII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA S. KERSEY

II. Dates (important events)

Enumeration Date: 05/24/2011
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 RIVERSIDE PKWY BLDG 2
GRAND JUNCTION CO
81501-4721
US

IV. Provider business mailing address

715 HORIZON DR STE 225
GRAND JUNCTION CO
81506-8743
US

V. Phone/Fax

Practice location:
  • Phone: 970-245-4213
  • Fax: 970-243-7297
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACB.0008449
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: