Provider Demographics
NPI:1497741789
Name:MEYER, ALLEN E (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:E
Last Name:MEYER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 D ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FAIRBURY
Mailing Address - State:NE
Mailing Address - Zip Code:68352-2318
Mailing Address - Country:US
Mailing Address - Phone:402-729-6379
Mailing Address - Fax:402-729-4094
Practice Address - Street 1:510 D ST
Practice Address - Street 2:SUITE 2
Practice Address - City:FAIRBURY
Practice Address - State:NE
Practice Address - Zip Code:68352-2318
Practice Address - Country:US
Practice Address - Phone:402-729-6379
Practice Address - Fax:402-729-4094
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE439103T00000X, 103TA0400X, 103TA0700X, 103TB0200X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE8529OtherMIDLANDS CHOICE
NE96007OtherBCBS AUXILIARY #
NE100249876-00Medicaid
NE680556319OtherTAX ID # & UBH #
NE08149OtherBCBS #
NE100249875-00Medicaid
NE100249876-00Medicaid
NE08149OtherBCBS #