Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 439 | NE |
Y | 103T00000X | Psychologist | 439 | NE |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 439 | NE |
N | 103TA0700X | Adult Development & Aging Psychologist | 439 | NE |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 439 | NE |
N | 103G00000X | Clinical Psychologist | 439 | NE |
N | 103TC0700X | Clinical Psychologist | 439 | NE |
N | 103TC1900X | Counseling Psychologist | 439 | NE |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 439 | NE |
N | 103TF0000X | Family Psychologist | 439 | NE |
N | 103TM1800X | Intellectual & Developmental Disabilities | 439 | NE |
NPI | 1497741789 |
---|---|
Provider Name | Dr. Allen E Meyer |
First Address | Fairbury, NE 68352-2318 |
Second Address | Fairbury, NE 68352-2318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2005 |
Last Update Date | 08/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08149 | BCBS # (01) | NE |
100249875-00 | (05) | NE |
100249876-00 | (05) | NE |
680556319 | TAX ID # & UBH # (01) | NE |
8529 | MIDLANDS CHOICE (01) | NE |
96007 | BCBS AUXILIARY # (01) | NE |
S57335 | (02) | NE |