Provider Demographics
NPI:1225333859
Name:MERIDIAN ASSOCIATES COUNSELING AND PREVENTION SERVICES, INC.
Entity Type:Organization
Organization Name:MERIDIAN ASSOCIATES COUNSELING AND PREVENTION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLEGG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:407-440-4509
Mailing Address - Street 1:200 E ROBINSON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1945
Mailing Address - Country:US
Mailing Address - Phone:407-440-4509
Mailing Address - Fax:407-440-4510
Practice Address - Street 1:200 E ROBINSON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1945
Practice Address - Country:US
Practice Address - Phone:407-440-4509
Practice Address - Fax:407-440-4510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty