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General NPI Number Information
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NPI Number | 1780999680
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Entity Type | Organization
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Legal Business Name | MEYER PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 08/08/2011
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Provider Practice Location Address
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Address Line | 238 S. CONGRESS OUTPATIENT CLINIC #3
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City | RUSHVILLE
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State | IL
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Zip | 62681
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Country | US
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Telephone | 217-322-2575
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Fax | 217-322-2574
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Provider Business Mailing Address
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Address Line | PO BOX 85
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City | RUSHVILLE
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State | IL
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Zip | 62681-0085
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Country | US
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Telephone | 217-322-2575
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Fax | 217-322-2574
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Authorized Official
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Title or Position | DR./OWNER/CEO
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Name | DR. PAMELA C. H. MEYER
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Credential | PSY.D., LCP
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Telephone | 217-322-2575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 098.000093
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License Number State | IL
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