Larry Meade, C.D.P.C, C.C.C
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Onalaska, WA
NPI 1811345580 · NPPES record last updated Jun 2, 2016
Key facts
- NPI
- 1811345580
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CP00005297 (WA)
- Practice address
- 1752 State Hwy 508
Onalaska, WA 98570-0485 - Phone
- (360) 978-4186
- Fax
- (360) 978-4926
- NPI assigned
- Jun 2, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP00005297 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fresh Start LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP00005297 | WA | Yes |
Addresses
Primary practice location
1752 State Hwy 508
Onalaska, WA 98570-0485
Mailing address
PO Box 485
1752 State Hwy 508
Onalaska, WA 98570-0485
Phone (360) 978-4186
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1996016 | Medicaid | WA |
Other providers in Onalaska, WA
- Fresh Start LLC
- Kathleen Henry
- Mark R Leadbetter
- Lewis County Community Health Services
- Lewis County Fire Protection District 1
- Marina V Olsen
- Onalaska School District
- Jeri Parks
- Erik Steven Plantiko
- Quintessential Birth Services
All providers in Onalaska, WA · Addiction (Substance Use Disorder) Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.