Provider Demographics
NPI:1164209144
Name:DUBOSE, MEGAN P (LPC ASSOCIATE, NCC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:P
Last Name:DUBOSE
Suffix:
Gender:F
Credentials:LPC ASSOCIATE, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 740671
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75374-0671
Mailing Address - Country:US
Mailing Address - Phone:214-785-8757
Mailing Address - Fax:
Practice Address - Street 1:9552 MEADOWKNOLL DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6114
Practice Address - Country:US
Practice Address - Phone:214-542-2160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health