Provider Demographics
NPI:1962804898
Name:MEYER, SEAN P (PHD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:P
Last Name:MEYER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 54723
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32245-4723
Mailing Address - Country:US
Mailing Address - Phone:904-239-3677
Mailing Address - Fax:904-239-3278
Practice Address - Street 1:6950 PHILIPS HWY STE 11
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6082
Practice Address - Country:US
Practice Address - Phone:904-239-3677
Practice Address - Fax:904-866-4029
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15725101YM0800X
OHE.2303934101YM0800X
101YP2500X
FLMH16268101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional