Provider Demographics
NPI:1811414006
Name:MEYER, KARI ELLEN (LPC, SAC)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ELLEN
Last Name:MEYER
Suffix:
Gender:F
Credentials:LPC, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 JEWELERS PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3893
Mailing Address - Country:US
Mailing Address - Phone:920-476-1992
Mailing Address - Fax:
Practice Address - Street 1:40 JEWELERS PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-3893
Practice Address - Country:US
Practice Address - Phone:920-720-6000
Practice Address - Fax:920-486-6013
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3559101YP2500X
WI7392-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional