Provider Demographics
NPI:1568062271
Name:MITCHELL, MEGAN JOANNE (LGPC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOANNE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:ME
Mailing Address - Zip Code:04255-0064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:471 HOWE HILL ROAD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:ME
Practice Address - Zip Code:04255
Practice Address - Country:US
Practice Address - Phone:410-916-2907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP8840101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional