Provider Demographics
NPI:1205408812
Name:MEYER, RICHARD F
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:F
Last Name:MEYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 N MILL ST STE H
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-4867
Mailing Address - Country:US
Mailing Address - Phone:630-366-9488
Mailing Address - Fax:
Practice Address - Street 1:1809 N MILL ST STE H
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4867
Practice Address - Country:US
Practice Address - Phone:630-366-9488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty