Healthcare Provider Details

I. General information

NPI: 1144778010
Provider Name (Legal Business Name): WARREN MEEHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2016
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2633 S LAPEER RD
ORION MI
48360-2810
US

IV. Provider business mailing address

665 ALAN DR
LAKE ORION MI
48362-2807
US

V. Phone/Fax

Practice location:
  • Phone: 248-274-4655
  • Fax:
Mailing address:
  • Phone: 845-821-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401226108
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: