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General NPI Number Information
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NPI Number | 1275293292
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Entity Type | Organization
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Legal Business Name | MEEHAN MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 12/20/2021
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 905 STANLEY AVE
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City | CLOQUET
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State | MN
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Zip | 55720-3186
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Country | US
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Telephone | 218-730-7862
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Fax |
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Provider Business Mailing Address
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Address Line | 65 SUNNARBORG RD
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City | ESKO
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State | MN
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Zip | 55733-9531
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Country | US
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Telephone | 218-730-7862
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | MRS. ANN CATHERINE MEEHAN
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Credential | MS, LPCC
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Telephone | 218-730-7862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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