Provider Demographics
NPI:1003290321
Name:HANEKOM, MEGAN (LPC, LAC, NCC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HANEKOM
Suffix:
Gender:F
Credentials:LPC, LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 FOX DR STE 110
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6880
Mailing Address - Country:US
Mailing Address - Phone:833-448-0127
Mailing Address - Fax:
Practice Address - Street 1:8800 FOX DR STE 110
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-6880
Practice Address - Country:US
Practice Address - Phone:833-448-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001323101YA0400X
COLPC.0015773101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health