Provider Demographics
NPI:1477207835
Name:JOHNSON, MEGAN M (HCS)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:M
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:HCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2104
Mailing Address - Country:US
Mailing Address - Phone:304-521-4365
Mailing Address - Fax:513-332-9072
Practice Address - Street 1:151 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3111
Practice Address - Country:US
Practice Address - Phone:304-235-3100
Practice Address - Fax:513-332-9072
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11217237700000X
KY262227237700000X
WV1100237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1100OtherWV STATE BOARD OF HEARING AID DEALERS LICENSE
OHTP11217OtherOHIO STATE LICENSE
KY262227OtherKENTUCKY STATE BOARD LICENSE