Provider Demographics
NPI:1437588480
Name:VAN METER, TINA (LCPC)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:VAN METER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:HERINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67449-0101
Mailing Address - Country:US
Mailing Address - Phone:785-268-2038
Mailing Address - Fax:620-487-2284
Practice Address - Street 1:222 W 6TH ST
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-5500
Practice Address - Country:US
Practice Address - Phone:913-353-6067
Practice Address - Fax:785-504-9344
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-09
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61299929101YM0800X
MO2023017555101YP2500X
KS03205101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health