Provider Demographics
NPI:1003252370
Name:MCINTIRE, MEGHAN B (LMHC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:B
Last Name:MCINTIRE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:C
Other - Last Name:BUCKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:397 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-1223
Mailing Address - Country:US
Mailing Address - Phone:508-791-3677
Mailing Address - Fax:508-791-3655
Practice Address - Street 1:397 GROVE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-1223
Practice Address - Country:US
Practice Address - Phone:508-791-3677
Practice Address - Fax:508-791-3655
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA9436101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor