Healthcare Provider Details

I. General information

NPI: 1508857186
Provider Name (Legal Business Name): E SEAN MEYER MA, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLEN SEAN O'CONNELL

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 PROGRESS RD
HANNIBAL MO
63401-6637
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 573-777-8300
  • Fax:
Mailing address:
  • Phone: 417-761-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180-002139
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 002874
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: