Provider Demographics
NPI:1649594607
Name:CASSIDY, MEGHAN (MAPC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:MAPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20280 E HUMMINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-3432
Mailing Address - Country:US
Mailing Address - Phone:480-298-5607
Mailing Address - Fax:
Practice Address - Street 1:7233 E BASELINE RD STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-5001
Practice Address - Country:US
Practice Address - Phone:480-298-5607
Practice Address - Fax:888-975-3287
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-19
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13476101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional