Provider Demographics
NPI:1851179287
Name:MERIDIEM PSYCHOLOGICAL SERVICES, INC
Entity Type:Organization
Organization Name:MERIDIEM PSYCHOLOGICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPE-I
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-765-9525
Mailing Address - Street 1:125 1/2 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3768
Mailing Address - Country:US
Mailing Address - Phone:501-765-9525
Mailing Address - Fax:501-745-2378
Practice Address - Street 1:125 1/2 N MARKET ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3768
Practice Address - Country:US
Practice Address - Phone:501-765-9525
Practice Address - Fax:501-745-2378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty