Provider Demographics
NPI:1326104217
Name:MEADOWS, JAMES R (PHD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:MEADOWS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1372 N SUSQUEHANNA TRL
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870-8971
Mailing Address - Country:US
Mailing Address - Phone:570-394-6656
Mailing Address - Fax:
Practice Address - Street 1:1372 N SUSQUEHANNA TRL
Practice Address - Street 2:SUITE 330
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-8971
Practice Address - Country:US
Practice Address - Phone:570-394-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE202584413OtherAETNA
NE10025268300Medicaid
NE85316OtherBCBS
NE241063OtherMIDLANDS CHOICE
NE85316OtherBCBS