Provider Demographics
NPI:1205866761
Name:MEYER, MARCIA MERICLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:MERICLE
Last Name:MEYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 N BELLEVIEW AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1507
Mailing Address - Country:US
Mailing Address - Phone:816-453-2600
Mailing Address - Fax:816-452-6890
Practice Address - Street 1:4444 N BELLEVIEW AVE STE 111
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-1507
Practice Address - Country:US
Practice Address - Phone:816-453-2600
Practice Address - Fax:816-452-6890
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO20201011OtherBCBSKC PROVIDER NUMBER