Provider Demographics
NPI:1477952638
Name:MEEKER, STEPHANIE MARIE (MSW, LISW, CADC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:MEEKER
Suffix:
Gender:F
Credentials:MSW, LISW, CADC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:FEICKERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LISW, CADC
Mailing Address - Street 1:4837 1ST AVE SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3226
Mailing Address - Country:US
Mailing Address - Phone:319-721-0765
Mailing Address - Fax:
Practice Address - Street 1:4837 1ST AVE SE
Practice Address - Street 2:SUITE 200
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3226
Practice Address - Country:US
Practice Address - Phone:319-721-0765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA10038101YA0400X
IA0071031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)