Provider Demographics
NPI:1366032567
Name:GARZAGLASS, MEGAN RENEE (LPC-S, RPT-S)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RENEE
Last Name:GARZAGLASS
Suffix:
Gender:F
Credentials:LPC-S, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 MEGELLAN POINT LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-6701
Mailing Address - Country:US
Mailing Address - Phone:916-834-9747
Mailing Address - Fax:
Practice Address - Street 1:2308 MEGELLAN POINT LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-6701
Practice Address - Country:US
Practice Address - Phone:916-834-9747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS2809101YM0800X
TX69255101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX69255OtherTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS
TXS2809OtherASSOCIATION FOR PLAY THERAPY