Provider Demographics
NPI:1114349206
Name:MCLEARON, MEGAN (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MCLEARON
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 FILER ST
Mailing Address - Street 2:SUITE 210G
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660-2726
Mailing Address - Country:US
Mailing Address - Phone:231-907-2412
Mailing Address - Fax:877-825-1865
Practice Address - Street 1:50 FILER ST
Practice Address - Street 2:SUITE 210G
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660-2726
Practice Address - Country:US
Practice Address - Phone:231-907-2412
Practice Address - Fax:877-825-1865
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional