Healthcare Provider Details

I. General information

NPI: 1497397822
Provider Name (Legal Business Name): GENTRI MEIER MS, LMHC, IADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2019
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 N JOHN WAYNE DR
WINTERSET IA
50273-1501
US

IV. Provider business mailing address

113 N JOHN WAYNE DR
WINTERSET IA
50273-1501
US

V. Phone/Fax

Practice location:
  • Phone: 515-462-5967
  • Fax: 515-462-5981
Mailing address:
  • Phone: 515-462-5967
  • Fax: 515-462-5981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number19012
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number089419
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: