Provider Demographics
NPI:1275198863
Name:HOUSE, MEGAN E (LMFT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:HOUSE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15715 LEMAY ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-6035
Mailing Address - Country:US
Mailing Address - Phone:818-585-9749
Mailing Address - Fax:
Practice Address - Street 1:520 S SEPULVEDA BLVD STE 309
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-3537
Practice Address - Country:US
Practice Address - Phone:818-585-9749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health