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General NPI Number Information
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NPI Number | 1225150139
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Entity Type | Organization
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Legal Business Name | MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5031 PARK LAKE ROAD
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City | EAST LANSING
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State | MI
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Zip | 48823-3835
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Country | US
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Telephone | 517-332-0811
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Fax | 517-332-4452
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Provider Business Mailing Address
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Address Line | 5031 PARK LAKE ROAD
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City | EAST LANSING
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State | MI
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Zip | 48823-3835
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Country | US
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Telephone | 517-332-0811
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Fax | 517-332-4452
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. BARBARA ANN GUNNINGS
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Credential | PHD LAC
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Telephone | 517-332-0811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 330070
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | MI
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