Provider Demographics
NPI:1467900597
Name:MEAGHER, MAUREEN THERESE (LPC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:THERESE
Last Name:MEAGHER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1381 STOUTAMIRE DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-4036
Mailing Address - Country:US
Mailing Address - Phone:540-815-6161
Mailing Address - Fax:
Practice Address - Street 1:221 ALBEMARLE AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4716
Practice Address - Country:US
Practice Address - Phone:540-815-6161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006518101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional