Provider Demographics
NPI:1841444023
Name:MEYER, KARRIE J (MA LAC)
Entity type:Individual
Prefix:MRS
First Name:KARRIE
Middle Name:J
Last Name:MEYER
Suffix:
Gender:F
Credentials:MA LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 E RAY RD
Mailing Address - Street 2:207
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8720
Mailing Address - Country:US
Mailing Address - Phone:480-888-6379
Mailing Address - Fax:
Practice Address - Street 1:1820 E RAY RD
Practice Address - Street 2:207
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8720
Practice Address - Country:US
Practice Address - Phone:480-888-6379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-12593101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional