Provider Demographics
NPI:1528622875
Name:MEINHARDT, MICHELE (LSCSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:MEINHARDT
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 E MAINSGATE RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1062
Mailing Address - Country:US
Mailing Address - Phone:316-202-5516
Mailing Address - Fax:
Practice Address - Street 1:6525 E MAINSGATE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1062
Practice Address - Country:US
Practice Address - Phone:316-202-5516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS47541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical