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General NPI Number Information
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NPI Number | 1063933091
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Entity Type | Organization
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Legal Business Name | MANDY MEYER COUNSELING, L.L.C.
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2804 2ND AVE
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City | KEARNEY
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State | NE
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Zip | 68847
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Country | US
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Telephone | 308-293-4203
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Fax |
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Provider Business Mailing Address
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Address Line | 69 LA PLATTE RD
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City | KEARNEY
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State | NE
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Zip | 68845-4852
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Country | US
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Telephone | 308-293-4203
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | MANDY M MEYER
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Credential | MA, LIMHP, LADC
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Telephone | 308-293-4203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 872
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1776
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License Number State | NE
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