MEDICARE: DR. MATTHEW A MEIER PSYD, HSP-P, LCAS

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	103TC0700X	Clinical Psychologist	2007030010	MO
2	103TC0700X	Clinical Psychologist	3774	NC
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	1405	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760460687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW A MEIER PSYD, HSP-P, LCAS

Provider Business Mailing Address
First Line	:	4112 BLUE RIDGE RD
Second Line	:	SUITE 200
City	:	RALEIGH
State	:	NC
Zip	:	27612-4652
Country	:	US
Telephone Number	:	919-573-6520
Fax Number	:	919-573-6554

Provider Business Practice Location Address
First Line	:	4112 BLUE RIDGE RD
Second Line	:	SUITE 200
City	:	RALEIGH
State	:	NC
Zip	:	27612-4652
Country	:	US
Telephone Number	:	919-573-6520
Fax Number	:	919-573-6554

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

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	08/21/2009

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