Healthcare Provider Details

I. General information

NPI: 1851624290
Provider Name (Legal Business Name): ANNETTE TERESA MEADOWS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2009
Last Update Date: 05/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2129 STATESVILLE BLVD
SALISBURY NC
28147-1411
US

IV. Provider business mailing address

2712 S CALHOUN ST
FORT WAYNE IN
46807-1402
US

V. Phone/Fax

Practice location:
  • Phone: 704-633-3616
  • Fax: 704-633-5902
Mailing address:
  • Phone: 260-744-4326
  • Fax: 260-744-0188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number14420
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: