Provider Demographics
NPI:1982716759
Name:MEISGEIER, LARRY MICHAEL (MA, MAT)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:MICHAEL
Last Name:MEISGEIER
Suffix:
Gender:M
Credentials:MA, MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5413 W LINCOLN AVE
Mailing Address - Street 2:APT. 5
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53219-1654
Mailing Address - Country:US
Mailing Address - Phone:414-327-7144
Mailing Address - Fax:
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:DOMICILIARY 123, VAMC
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health