Provider Demographics
NPI:1376855601
Name:SHELTON, MEGAN ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:SHELTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:UBINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1 CHILDRENS PL
Mailing Address - Street 2:ST. LOUIS CHILDREN'S HOSPITAL, SUITE 3N-14
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1077
Mailing Address - Country:US
Mailing Address - Phone:314-454-6069
Mailing Address - Fax:314-454-4013
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:ST. LOUIS CHILDREN'S HOSPITAL, SUITE 3N-14
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1077
Practice Address - Country:US
Practice Address - Phone:314-454-6069
Practice Address - Fax:314-454-4013
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011032561103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1376855601Medicaid