Provider Demographics
NPI:1144430638
Name:MEYER, DIANA (MA LPC NCC)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:MA LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11676 PERRY HWY
Mailing Address - Street 2:SUITE 2309
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7201
Mailing Address - Country:US
Mailing Address - Phone:412-443-1919
Mailing Address - Fax:
Practice Address - Street 1:11676 PERRY HWY
Practice Address - Street 2:SUITE 2309
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7201
Practice Address - Country:US
Practice Address - Phone:412-443-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003848101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA75332OtherNBCC