Provider Demographics
NPI:1366637118
Name:CLAVEL-CARDOZA, MERIDITH (LCMFT)
Entity Type:Individual
Prefix:
First Name:MERIDITH
Middle Name:
Last Name:CLAVEL-CARDOZA
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:MERIDITH
Other - Middle Name:
Other - Last Name:ROWLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:509 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-2353
Mailing Address - Country:US
Mailing Address - Phone:800-423-1342
Mailing Address - Fax:785-628-3113
Practice Address - Street 1:4155 E HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3725
Practice Address - Country:US
Practice Address - Phone:800-423-1342
Practice Address - Fax:785-628-3113
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS348106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200475200CMedicaid