MEDICARE: JAMES R MEADOWS PH.D.

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
1	101YM0800X	Mental Health Counselor	2600	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	202584413	OTHER	NE	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	85316	OTHER	NE	BCBS
4	241063	OTHER	NE	MIDLANDS CHOICE

General Provider Information

NPI Number	:	1326104217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES R MEADOWS PH.D.

Provider Business Mailing Address
First Line	:	1372 N SUSQUEHANNA TRL
Second Line	:	SUITE 330
City	:	SELINSGROVE
State	:	PA
Zip	:	17870-8971
Country	:	US
Telephone Number	:	570-394-6656
Fax Number	:

Provider Business Practice Location Address
First Line	:	1372 N SUSQUEHANNA TRL
Second Line	:	SUITE 330
City	:	SELINSGROVE
State	:	PA
Zip	:	17870-8971
Country	:	US
Telephone Number	:	570-394-6656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	09/15/2011

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Directions to “ JAMES R MEADOWS PH.D.” Practice Location

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