GLEN EDGAR MELDAHL LPC NPI 1790064624

NPI Information

  • NPI: 1790064624
  • Provider Name: GLEN EDGAR MELDAHL, LPC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 2126 N 1ST STREET
    SUITE F
    JACKSONVILLE, AR
    ZIP 72076
  • Phone: (501) 982-5000

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NPI Details

Glen Edgar Meldahl, LPC is a mental health counselor in Jacksonville, AR. Glen Edgar Meldahl, LPC NPI is 1790064624. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2126 N 1ST STREET
SUITE F
JACKSONVILLE, AR
ZIP 72076-868
Phone: (501) 982-5000
Fax: (501) 982-5007

The enumeration date for this NPI number is 8/9/2011 and was last updated on 11/10/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthP9503006ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1187842795MEDICAIDARKANSAS
25T153OTHERARKANSASBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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