Provider Demographics
NPI:1093054454
Name:MCPHERSON, MEAGAN MICHELL (LPC, MED, NCC)
Entity Type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:MICHELL
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:LPC, MED, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 FERNCLIFF CV
Mailing Address - Street 2:SUITE NUMBER 2
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-2433
Mailing Address - Country:US
Mailing Address - Phone:662-342-2700
Mailing Address - Fax:662-342-7300
Practice Address - Street 1:885 FERNCLIFF CV
Practice Address - Street 2:SUITE NUMBER 2
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-2433
Practice Address - Country:US
Practice Address - Phone:662-342-2700
Practice Address - Fax:662-342-7300
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1727101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional