Provider Demographics
NPI:1407518384
Name:LANDSTEINER, MEGAN ADDISON (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ADDISON
Last Name:LANDSTEINER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:MEGAN
Other - Middle Name:LANDSTEINER
Other - Last Name:BRUNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:308 LIVE OAK AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-7239
Mailing Address - Country:US
Mailing Address - Phone:239-848-0919
Mailing Address - Fax:
Practice Address - Street 1:308 LIVE OAK AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-7239
Practice Address - Country:US
Practice Address - Phone:239-848-0919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12102101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health