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NPI Code Detail

MEDICARE: MEREDITH HOWARD MCENENY M. ED, LPC INTERN

MEDICARE: MEREDITH HOWARD MCENENY M. ED, LPC INTERN
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 Counselor62748TX

General Provider Information

NPI Number : 1891817003
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEREDITH HOWARD MCENENY M. ED, LPC INTERN
Provider Business Mailing Address
First Line : 4317 LARCHMONT ST
Second Line :
City : DALLAS
State : TX
Zip : 75205-1618
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4701 SAMUELL BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75228-6828
Country : US
Telephone Number : 214-381-7070
Fax Number : 214-381-7071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 07/08/2007

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