Provider Demographics
NPI:1225381403
Name:LISA K.S. MEEK, PSYD, PC
Entity Type:Organization
Organization Name:LISA K.S. MEEK, PSYD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MEEK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:719-358-3432
Mailing Address - Street 1:945 OAK BEND CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1419
Mailing Address - Country:US
Mailing Address - Phone:719-358-3432
Mailing Address - Fax:719-260-0751
Practice Address - Street 1:5350 TOMAH DR STE 3600
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6991
Practice Address - Country:US
Practice Address - Phone:719-358-3432
Practice Address - Fax:719-260-0751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3457103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty