MEDICARE: DR. KRISTIN K. MEANY-WALEN PHD, LMHC, RPT-S

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	101Y00000X	Counselor	64177	TX
2	101Y00000X	Counselor	001407	IA

General Provider Information

NPI Number	:	1851611594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTIN K. MEANY-WALEN PHD, LMHC, RPT-S

Provider Business Mailing Address
First Line	:	140 TAYLOR LN
Second Line	:
City	:	RAYMOND
State	:	IA
Zip	:	50667-9104
Country	:	US
Telephone Number	:	940-255-9526
Fax Number	:

Provider Business Practice Location Address
First Line	:	6315 CHANCELLOR DR
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-6919
Country	:	US
Telephone Number	:	940-255-9526
Fax Number	:

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

Provider Enumeration Date	:	06/04/2010
Last Update Date	:	12/01/2022

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