Healthcare Provider Details

I. General information

NPI: 1235616418
Provider Name (Legal Business Name): HOLLY MEYERS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2018
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 N BAUGHMAN ST
ULYSSES KS
67880-2058
US

IV. Provider business mailing address

PO BOX 477
GARDEN CITY KS
67846-0477
US

V. Phone/Fax

Practice location:
  • Phone: 620-356-3198
  • Fax: 620-356-3101
Mailing address:
  • Phone: 620-275-0644
  • Fax: 620-272-0239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3316
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3282
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: