=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184044745
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEAGEN MEALER-GOSIEWSKI LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/22/2014
-----------------------------------------------------
Last Update Date | 04/22/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11 HOMEWOOD DR
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28803-1242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-450-3947
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 HOMEWOOD DR
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28803-1242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-450-3947
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | A10047
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------