Basic Information
| Provider Information | |||||||||
| NPI: | 1336471648 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MELDAHL | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3258 SWADLEY ST | ||||||||
| Address2: | |||||||||
| City: | WHEAT RIDGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800335313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7203642053 | ||||||||
| FaxNumber: | 3033204290 | ||||||||
| Practice Location | |||||||||
| Address1: | 1295 YORK ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802063008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033203790 | ||||||||
| FaxNumber: | 3033204290 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2010 | ||||||||
| LastUpdateDate: | 02/11/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | LPC 5549 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.