MEDICARE: STEPHANIE MEEHAN

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	235Z00000X	Speech-Language Pathologist	3268	KS
2	235Z00000X	Speech-Language Pathologist	146.018274	IL

General Provider Information

NPI Number	:	1972904712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MEEHAN

Provider Business Mailing Address
First Line	:	2105 HAWORTH
Second Line	:	1200 SUNNYSIDE AVE.
City	:	LAWRENCE
State	:	KS
Zip	:	66045-7600
Country	:	US
Telephone Number	:	785-864-0649
Fax Number	:

Provider Business Practice Location Address
First Line	:	2105 HAWORTH
Second Line	:	1200 SUNNYSIDE AVE.
City	:	LAWRENCE
State	:	KS
Zip	:	66045-7600
Country	:	US
Telephone Number	:	785-864-0649
Fax Number	:

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

Provider Enumeration Date	:	09/11/2014
Last Update Date	:	10/31/2025

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Directions to “ STEPHANIE MEEHAN ” Practice Location

Language	Start Address	Practice Location

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