Provider Demographics
NPI:1912335340
Name:MEINECKE, ALISON (MS, PLPC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:MEINECKE
Suffix:
Gender:F
Credentials:MS, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 MACE RD
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-9723
Mailing Address - Country:US
Mailing Address - Phone:660-748-8405
Mailing Address - Fax:
Practice Address - Street 1:1091 MIDWAY DR
Practice Address - Street 2:
Practice Address - City:LINN CREEK
Practice Address - State:MO
Practice Address - Zip Code:65052-1687
Practice Address - Country:US
Practice Address - Phone:573-346-6758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013035393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health