Provider Demographics
NPI:1386986461
Name:MEADOR, CURTIS VANN (MDIV)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:VANN
Last Name:MEADOR
Suffix:
Gender:M
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4206 N ARNOLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3012
Mailing Address - Country:US
Mailing Address - Phone:404-884-8064
Mailing Address - Fax:770-384-8658
Practice Address - Street 1:4206 N ARNOLD MILL RD
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3012
Practice Address - Country:US
Practice Address - Phone:404-884-8064
Practice Address - Fax:770-384-8658
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral