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NPI Code Detail

MEDICARE: MEREDITH TRANK M.A., M.DIV.

MEDICARE: MEREDITH TRANK M.A., M.DIV.
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578254314
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEREDITH TRANK M.A., M.DIV.
Provider Business Mailing Address
First Line : 1236 COLLEGIAN TER
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27106-6340
Country : US
Telephone Number : 512-921-1033
Fax Number :
Provider Business Practice Location Address
First Line : 6300 N REVERE DR STE 270
Second Line :
City : KANSAS CITY
State : MO
Zip : 64151-3919
Country : US
Telephone Number : 913-735-0577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2023
Last Update Date : 05/15/2023

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