Healthcare Provider Details

I. General information

NPI: 1962804898
Provider Name (Legal Business Name): SEAN P MEYER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 PHILIPS HWY STE 11
JACKSONVILLE FL
32216-6082
US

IV. Provider business mailing address

PO BOX 54723
JACKSONVILLE FL
32245-4723
US

V. Phone/Fax

Practice location:
  • Phone: 904-239-3677
  • Fax: 904-866-4029
Mailing address:
  • Phone: 904-239-3677
  • Fax: 904-239-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15725
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2303934
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number103632
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180016965
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH16268
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: