Provider Demographics
NPI:1043801574
Name:VANT, MEGAN (MA, LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:VANT
Suffix:
Gender:F
Credentials:MA, LCPC, CADC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:FINCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 19639
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62794-9639
Mailing Address - Country:US
Mailing Address - Phone:217-545-8000
Mailing Address - Fax:844-470-2486
Practice Address - Street 1:425 E STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-2125
Practice Address - Country:US
Practice Address - Phone:217-408-1195
Practice Address - Fax:217-408-1231
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2024-03-01
Deactivation Date:2022-06-17
Deactivation Code:
Reactivation Date:2024-02-28
Provider Licenses
StateLicense IDTaxonomies
IL35480101YA0400X
IL180.015751101YA0400X, 101YP2500X
IL178.016026101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health