Provider Demographics
NPI:1407957293
Name:MEAU, A MARK (MED, LCMHC)
Entity Type:Individual
Prefix:
First Name:A
Middle Name:MARK
Last Name:MEAU
Suffix:
Gender:M
Credentials:MED, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03235-2026
Mailing Address - Country:US
Mailing Address - Phone:603-934-0177
Mailing Address - Fax:603-934-2805
Practice Address - Street 1:841 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2026
Practice Address - Country:US
Practice Address - Phone:603-934-0177
Practice Address - Fax:603-934-2805
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH377101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health