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General NPI Number Information
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NPI Number | 1578397212
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Entity Type | Individual
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Provider Name | MELISSA MEYER LAC
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Gender | Female
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Dates
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Enumeration Date | 08/27/2024
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 1560 W BEEBE CAPPS EXPY STE B
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City | SEARCY
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State | AR
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Zip | 72143-5176
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Country | US
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Telephone | 501-451-5891
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Fax | 501-451-5891
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Provider Business Mailing Address
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Address Line | 1310 W MAIN ST STE 201
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-2803
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A2602010
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License Number State | AR
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