Provider Demographics
NPI:1558876698
Name:MEYER, CHARLOTTE MARIE (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:MARIE
Last Name:MEYER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:MARIE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:6120 EARLE BROWN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-4100
Mailing Address - Country:US
Mailing Address - Phone:763-277-1020
Mailing Address - Fax:763-537-7162
Practice Address - Street 1:1585 RICE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-3751
Practice Address - Country:US
Practice Address - Phone:651-487-8088
Practice Address - Fax:651-487-8105
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01348101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional