Healthcare Provider Details

I. General information

NPI: 1548279615
Provider Name (Legal Business Name): JEFFERY T. MEECH, PSYD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 W. HANLEY AVE STE 101
COEUR D'ALENE ID
83815-8994
US

IV. Provider business mailing address

509 W. HANLEY AVE STE 101
COEUR D'ALENE ID
83815-8994
US

V. Phone/Fax

Practice location:
  • Phone: 208-666-0357
  • Fax: 208-666-0468
Mailing address:
  • Phone: 208-666-0357
  • Fax: 208-666-0468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY5143
License Number StateFL

VIII. Authorized Official

Name: DR. JEFFERY THOMAS MEECH
Title or Position: OWNER/PSYCHOLOGIST
Credential: PSY D, MSCP
Phone: 208-666-0357