Provider Demographics
NPI:1548301518
Name:MEYER, VICKI L (LMHP)
Entity type:Individual
Prefix:MS
First Name:VICKI
Middle Name:L
Last Name:MEYER
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 460602
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-0602
Mailing Address - Country:US
Mailing Address - Phone:402-616-7314
Mailing Address - Fax:402-564-0918
Practice Address - Street 1:7907 BEAMAN STREET
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-4298
Practice Address - Country:US
Practice Address - Phone:402-616-7314
Practice Address - Fax:402-564-0918
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2458101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025549800Medicaid