Provider Demographics
NPI:1447600432
Name:MEULMAN, JOHN-MARK (LPC, LCDC)
Entity type:Individual
Prefix:
First Name:JOHN-MARK
Middle Name:
Last Name:MEULMAN
Suffix:
Gender:M
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 POLK ST N
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-2232
Mailing Address - Country:US
Mailing Address - Phone:214-277-3676
Mailing Address - Fax:
Practice Address - Street 1:900 E PARK BLVD STE 280
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-8862
Practice Address - Country:US
Practice Address - Phone:214-277-3676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120504101YA0400X
TX72067101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)