Healthcare Provider Details

I. General information

NPI: 1871248195
Provider Name (Legal Business Name): ELIZABETH HOPE MEEKS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 BROADWAY ST
VINCENNES IN
47591-1251
US

IV. Provider business mailing address

105 BROADWAY ST
VINCENNES IN
47591-1251
US

V. Phone/Fax

Practice location:
  • Phone: 812-886-3000
  • Fax: 812-886-3010
Mailing address:
  • Phone: 812-790-2599
  • Fax: 812-790-2187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34009162A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: