Provider Demographics
NPI:1134147127
Name:MEYER, NONA M (LISW)
Entity type:Individual
Prefix:MS
First Name:NONA
Middle Name:M
Last Name:MEYER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12289 STRATFORD DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8167
Mailing Address - Country:US
Mailing Address - Phone:515-225-9777
Mailing Address - Fax:515-225-9780
Practice Address - Street 1:12289 STRATFORD DR
Practice Address - Street 2:SUITE B
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8167
Practice Address - Country:US
Practice Address - Phone:515-225-9777
Practice Address - Fax:515-225-9780
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA50570OtherBLUECROSS/BLUESHIELD
IA50570OtherBLUECROSS/BLUESHIELD