Provider Demographics
NPI:1407609928
Name:MEECE, JAMIE (CHAPLAIN, PSS)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:
Last Name:MEECE
Suffix:
Gender:U
Credentials:CHAPLAIN, PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DEPOT STREET
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:KY
Mailing Address - Zip Code:42567
Mailing Address - Country:US
Mailing Address - Phone:606-875-3719
Mailing Address - Fax:606-280-9971
Practice Address - Street 1:100 DEPOT STREET
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:KY
Practice Address - Zip Code:42567
Practice Address - Country:US
Practice Address - Phone:606-875-3719
Practice Address - Fax:606-280-9971
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYNONE101YP1600X
TN25427207PE0004X
TN0489207PE0004X
KY1037263207PE0004X
KY1202445101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services