Provider Demographics
NPI:1376190504
Name:EARP, MEGAN JANE (LMHC INTERN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JANE
Last Name:EARP
Suffix:
Gender:F
Credentials:LMHC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N 3RD ST STE 209
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-2483
Mailing Address - Country:US
Mailing Address - Phone:888-870-1775
Mailing Address - Fax:
Practice Address - Street 1:500 N 3RD ST STE 209
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-2483
Practice Address - Country:US
Practice Address - Phone:888-870-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health