Provider Demographics
NPI:1760460687
Name:MEIER, MATTHEW A (PSYD, HSP-P, LCAS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:MEIER
Suffix:
Gender:M
Credentials:PSYD, HSP-P, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4112 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4652
Mailing Address - Country:US
Mailing Address - Phone:919-573-6520
Mailing Address - Fax:919-573-6554
Practice Address - Street 1:4112 BLUE RIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4652
Practice Address - Country:US
Practice Address - Phone:919-573-6520
Practice Address - Fax:919-573-6554
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007030010103TC0700X
NC3774103TC0700X
NC1405101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO497364802Medicaid
NC6001155Medicaid