Provider Demographics
NPI:1083329536
Name:GURESH, MEGAN (LGPC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:GURESH
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 COLONIAL MANOR CT
Mailing Address - Street 2:
Mailing Address - City:LEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19533-9417
Mailing Address - Country:US
Mailing Address - Phone:201-661-0123
Mailing Address - Fax:
Practice Address - Street 1:205 WARRENTON DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2848
Practice Address - Country:US
Practice Address - Phone:484-248-1045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC14652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health