Individual provider Active NPI

Angie Meilahn

  • School Psychologist
  • New Smyrna Beach, FL
National Provider Identifier
1205512563
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
3590004268 Issued in WI
Practice address
1804 Red Rock Rd
New Smyrna Beach, FL 32168-9340
Phone
(386) 847-4422
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 3590004268 WI Primary

Addresses

Primary practice location

1804 Red Rock Rd
New Smyrna Beach, FL 32168-9340

Mailing address

1804 Red Rock Rd
New Smyrna Beach, FL 32168-9340
Phone (386) 847-4422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3590004268WIMDSchool Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1205512563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 RED ROCK RD",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321689340",
            "telephone_number": "386-847-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 RED ROCK RD",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321689340",
            "telephone_number": "386-847-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEILAHN",
        "first_name": "ANGIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-07-14",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WI",
            "license": "3590004268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.