1972735678 NPI number — DR. MONEE NOEL MERRIWEATHER PSYD

Table of content: DR. MONEE NOEL MERRIWEATHER PSYD (NPI 1972735678)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972735678 NPI number — DR. MONEE NOEL MERRIWEATHER PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MERRIWEATHER
Provider First Name:
MONEE
Provider Middle Name:
NOEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972735678
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 874
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DULUTH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30096-0016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-665-2562
Provider Business Mailing Address Fax Number:
866-269-4084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1509 ATKINSON RD
Provider Second Line Business Practice Location Address:
SUITE 2200
Provider Business Practice Location Address City Name:
LAWRENCEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30043-7986
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-665-2562
Provider Business Practice Location Address Fax Number:
866-269-4084
Provider Enumeration Date:
08/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LPC13057 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: LPC004470 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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