Provider Demographics
NPI:1093157216
Name:HOLTON, MEGAN (LPC, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:HOLTON
Suffix:
Gender:F
Credentials:LPC, BCBA
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:DAVELINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, BCBA
Mailing Address - Street 1:1455 DIXON AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8879
Mailing Address - Country:US
Mailing Address - Phone:033-443-8500
Mailing Address - Fax:
Practice Address - Street 1:1455 DIXON AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8879
Practice Address - Country:US
Practice Address - Phone:033-443-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013343101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional