Basic Information
| Provider Information | |||||||||
| NPI: | 1376092098 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEINTS | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | MAE | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 44 VANTAGE WAY | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372281513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154636658 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2615 EDWARDS ST | ||||||||
| Address2: | |||||||||
| City: | ALTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 620023915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184622331 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2016 | ||||||||
| LastUpdateDate: | 02/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 178.011744 | IL | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101Y00000X | 180.011913 | IL | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.