Provider Demographics
NPI:1790080141
Name:MEIDLING, BECKY STARR (MT-BC, CAP, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:STARR
Last Name:MEIDLING
Suffix:
Gender:F
Credentials:MT-BC, CAP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PRUDENTIAL DR
Mailing Address - Street 2:HOWARD 510
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8202
Mailing Address - Country:US
Mailing Address - Phone:904-202-4518
Mailing Address - Fax:904-202-2436
Practice Address - Street 1:800 PRUDENTIAL DR
Practice Address - Street 2:HOWARD 510
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8202
Practice Address - Country:US
Practice Address - Phone:904-202-4518
Practice Address - Fax:904-202-2436
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 7717101Y00000X
FL2552W101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)