Provider Demographics
NPI:1467933259
Name:BURELLI, MEAGEN (LPCA)
Entity Type:Individual
Prefix:
First Name:MEAGEN
Middle Name:
Last Name:BURELLI
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16600 BIRKDALE COMMONS PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6181
Mailing Address - Country:US
Mailing Address - Phone:704-564-0300
Mailing Address - Fax:
Practice Address - Street 1:16600 BIRKDALE COMMONS PKWY STE D
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6181
Practice Address - Country:US
Practice Address - Phone:704-564-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health