Provider Demographics
NPI:1174896922
Name:MEISTER, ALAN JOEL (LADC1)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:JOEL
Last Name:MEISTER
Suffix:
Gender:M
Credentials:LADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 RICHARD RD
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1757
Mailing Address - Country:US
Mailing Address - Phone:508-533-8336
Mailing Address - Fax:
Practice Address - Street 1:497 BELLEVILLE AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02746-5432
Practice Address - Country:US
Practice Address - Phone:774-213-8364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2197101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor