Provider Demographics
NPI:1548484280
Name:MEIER, MICHAEL JOHN (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:MEIER
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 1:402 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:KY
Mailing Address - Zip Code:41071-3208
Mailing Address - Country:US
Mailing Address - Phone:859-781-2070
Mailing Address - Fax:
Practice Address - Street 1:12 E 5TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:KY
Practice Address - Zip Code:41071-1618
Practice Address - Country:US
Practice Address - Phone:859-331-3292
Practice Address - Fax:859-578-2864
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00077661041C0700X
KYKY 9101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY610661458OtherTAX ID