Provider Demographics
NPI:1437649514
Name:THOMAS, MEAGAN BRASWELL (LCMHCA)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:BRASWELL
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FOUNTAIN BROOK CIR STE B
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4478
Mailing Address - Country:US
Mailing Address - Phone:972-741-5320
Mailing Address - Fax:
Practice Address - Street 1:106 FOUNTAIN BROOK CIR STE B
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4478
Practice Address - Country:US
Practice Address - Phone:972-741-5320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10623101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty