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NPI Code Detail

MEDICARE: LISA K.S. MEEK, PSYD, PC

MEDICARE: LISA K.S. MEEK, PSYD, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist3457CO

General Provider Information

NPI Number : 1225381403
Entity Type Code : Organization
Provider Name (Legal Business Name) : LISA K.S. MEEK, PSYD, PC
Provider Business Mailing Address
First Line : 945 OAK BEND CT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-1419
Country : US
Telephone Number : 719-358-3432
Fax Number : 719-260-0751
Provider Business Practice Location Address
First Line : 5350 TOMAH DR STE 3600
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-6991
Country : US
Telephone Number : 719-358-3432
Fax Number : 719-260-0751
Authorized Official
Title or Position : OWNER
Name : LISA K MEEK
Credential : PSYD
Telephone Number : 719-358-3432
Provider Enumeration Date : 10/24/2012
Last Update Date : 10/24/2012

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