Provider Demographics
NPI:1467049676
Name:LEDERMAN, MEGAN (MA LPC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LEDERMAN
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CLARENDON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-3933
Mailing Address - Country:US
Mailing Address - Phone:413-734-9070
Mailing Address - Fax:
Practice Address - Street 1:301 OXFORD VALLEY RD STE 601B
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7712
Practice Address - Country:US
Practice Address - Phone:215-337-3993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health