Provider Demographics
NPI:1316569643
Name:MEADOWLARK COUNSELING, LLC
Entity Type:Organization
Organization Name:MEADOWLARK COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARTIN NISLY
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:620-960-7414
Mailing Address - Street 1:PO BOX 51
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67514-0051
Mailing Address - Country:US
Mailing Address - Phone:620-960-7414
Mailing Address - Fax:620-259-7994
Practice Address - Street 1:1 N MAIN ST STE 416
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-5250
Practice Address - Country:US
Practice Address - Phone:620-960-7414
Practice Address - Fax:888-516-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200452020GMedicaid