Healthcare Provider Details

I. General information

NPI: 1003385956
Provider Name (Legal Business Name): GARY M MEIER LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2018
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 JEROME AVE APT 5E
BRONX NY
10452-5755
US

IV. Provider business mailing address

941 JEROME AVE APT 5E
BRONX NY
10452-5755
US

V. Phone/Fax

Practice location:
  • Phone: 314-422-4111
  • Fax:
Mailing address:
  • Phone: 314-422-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number009164
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: