Provider Demographics
NPI:1417364209
Name:MCDONNELL, MEGAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:MCDONNELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:HICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:190 SW BROAD ST UNIT 1203
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28388-0104
Mailing Address - Country:US
Mailing Address - Phone:910-408-2525
Mailing Address - Fax:
Practice Address - Street 1:225 N BENNETT ST STE F
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-4810
Practice Address - Country:US
Practice Address - Phone:910-408-2525
Practice Address - Fax:888-546-3945
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5390103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist