Provider Demographics
NPI:1629562566
Name:MITCHELL, MEGAN LAINE (LMHCA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LAINE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 EASTMONT AVE
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5306
Mailing Address - Country:US
Mailing Address - Phone:509-663-0034
Mailing Address - Fax:
Practice Address - Street 1:220 EASTMONT AVE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5306
Practice Address - Country:US
Practice Address - Phone:509-663-0034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60867461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health