Provider Demographics
NPI:1194188524
Name:MEYER CLINICAL COUNSELING, INC.
Entity type:Organization
Organization Name:MEYER CLINICAL COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, CADC, NCC
Authorized Official - Phone:630-267-5432
Mailing Address - Street 1:535 S WASHINGTON ST
Mailing Address - Street 2:SUITE 27
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6795
Mailing Address - Country:US
Mailing Address - Phone:630-267-5432
Mailing Address - Fax:
Practice Address - Street 1:535 S WASHINGTON ST
Practice Address - Street 2:SUITE 27
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6795
Practice Address - Country:US
Practice Address - Phone:630-267-5432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-02
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009896101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty