Provider Demographics
NPI:1023361136
Name:DOYLE, MEGAN LEIGH (LPCMH,NCC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEIGH
Last Name:DOYLE
Suffix:
Gender:F
Credentials:LPCMH,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRANDYWINE BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLEYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19803-1838
Mailing Address - Country:US
Mailing Address - Phone:302-703-7779
Mailing Address - Fax:302-467-2920
Practice Address - Street 1:19 BRANDYWINE BLVD
Practice Address - Street 2:
Practice Address - City:TALLEYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19803-1838
Practice Address - Country:US
Practice Address - Phone:302-703-7779
Practice Address - Fax:302-467-2920
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2023-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000614101YM0800X
DEPC0000614101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1023361136Medicaid