Provider Demographics
NPI:1023717485
Name:MEADOW CREEK COUNSELING LLC
Entity type:Organization
Organization Name:MEADOW CREEK COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMPSON TEXIDOR
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:720-808-0139
Mailing Address - Street 1:7018 RAINELLE DR
Mailing Address - Street 2:
Mailing Address - City:LANESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47136-9478
Mailing Address - Country:US
Mailing Address - Phone:303-717-4039
Mailing Address - Fax:720-828-6096
Practice Address - Street 1:400 PEARL ST STE 202B
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-3451
Practice Address - Country:US
Practice Address - Phone:720-808-0139
Practice Address - Fax:720-828-6096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty