Provider Demographics
NPI:1154028645
Name:MEADOWLARK COUNSELING PLLC
Entity type:Organization
Organization Name:MEADOWLARK COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LANAE
Authorized Official - Last Name:KIZIMA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LMSW
Authorized Official - Phone:701-720-7733
Mailing Address - Street 1:PO BOX 3339
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-3339
Mailing Address - Country:US
Mailing Address - Phone:701-720-7733
Mailing Address - Fax:
Practice Address - Street 1:600 22ND AVE NW STE B4
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-0986
Practice Address - Country:US
Practice Address - Phone:701-720-7733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)