Provider Demographics
NPI:1447435920
Name:MEYER, MANDY M (LMHP, LADC)
Entity type:Individual
Prefix:
First Name:MANDY
Middle Name:M
Last Name:MEYER
Suffix:
Gender:F
Credentials:LMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 LA PLATTE RD
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-4852
Mailing Address - Country:US
Mailing Address - Phone:308-293-4203
Mailing Address - Fax:
Practice Address - Street 1:2804 2ND AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-3500
Practice Address - Country:US
Practice Address - Phone:308-293-4203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3303101YM0800X
NE1776101YM0800X
NE872101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)