Healthcare Provider Details

I. General information

NPI: 1194188524
Provider Name (Legal Business Name): MEYER CLINICAL COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2016
Last Update Date: 02/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 S WASHINGTON ST SUITE 27
NAPERVILLE IL
60540-6795
US

IV. Provider business mailing address

535 S WASHINGTON ST SUITE 27
NAPERVILLE IL
60540-6795
US

V. Phone/Fax

Practice location:
  • Phone: 630-267-5432
  • Fax:
Mailing address:
  • Phone: 630-267-5432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number180.009896
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.009896
License Number StateIL

VIII. Authorized Official

Name: MS. CHRISTY D. MEYER
Title or Position: OWNER/PRESIDENT
Credential: LCPC, CADC, NCC
Phone: 630-267-5432