Provider Demographics
NPI:1003632985
Name:MEEKS, HARRY R JR (AMFT)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:R
Last Name:MEEKS
Suffix:JR
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9025 WEST LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-1401
Mailing Address - Country:US
Mailing Address - Phone:209-957-4027
Mailing Address - Fax:
Practice Address - Street 1:315 W PINE ST STE 3
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-2074
Practice Address - Country:US
Practice Address - Phone:209-366-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health