Active NPI
Michael Patrick Meehan, PH.D.
- Psychologist
- Saint Louis, MO
National Provider Identifier
1902417108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1999140391
- Practice address
- 330 N Gore Ave
Saint Louis, MO 63119-1600 - Phone
- (314) 750-5026
- NPI assigned
- Aug 11, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1999140391 | MO | Primary |
Addresses
Primary practice location
330 N Gore Ave
Saint Louis, MO 63119-1600
Mailing address
498 Meadow Green PL
Creve Coeur, MO 63141-7443
Phone (314) 809-6140
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1999140391 | MO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600387200000",
"number": "1902417108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "498 MEADOW GREEN PL",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417443",
"telephone_number": "314-809-6140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 N GORE AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631191600",
"telephone_number": "314-750-5026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEEHAN",
"first_name": "MICHAEL",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-11",
"last_updated": "2020-09-18",
"certification_date": "2020-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "1999140391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.