Meldahl, Glen Edgar

Meldahl, Glen Edgar is an individual health care provider with primary practice located at 2126 N 1St Street Suite F, Jacksonville AR 72076-2868. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Meldahl, Glen Edgar can be contacted via phone (501) 982-5000.

Contact Information

Primary practice address
2126 N 1St Street Suite F Jacksonville AR 72076-2868
Phone: (501) 982-5000
Fax: (501) 982-5007
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X P9503006 Arkansas

Profile Details

NPI number 1790064624
LBN Legal business name Meldahl, Glen Edgar
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2011
Last updated Nov 10th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790064624 NPPES
Arkansas MEDICAID 187842795
Arkansas Other 5T153

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