MEDICARE: SUZANNE E MEYER LPC

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	101YP2500X	Professional Counselor	0011521	CO

General Provider Information

NPI Number	:	1598106932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE E MEYER LPC

Provider Business Mailing Address
First Line	:	617 N 17TH ST STE 201
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-3580
Country	:	US
Telephone Number	:	719-330-5733
Fax Number	:

Provider Business Practice Location Address
First Line	:	617 N 17TH ST STE 201
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-3580
Country	:	US
Telephone Number	:	719-330-5733
Fax Number	:

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

Provider Enumeration Date	:	07/15/2013
Last Update Date	:	09/11/2020

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