Provider Demographics
NPI:1710105259
Name:SIXBEY, MEGGEN TUCKER (PHD, LMHC, NCC)
Entity Type:Individual
Prefix:DR
First Name:MEGGEN
Middle Name:TUCKER
Last Name:SIXBEY
Suffix:
Gender:F
Credentials:PHD, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 NW 65TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6356
Mailing Address - Country:US
Mailing Address - Phone:352-871-7787
Mailing Address - Fax:
Practice Address - Street 1:6216 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-8860
Practice Address - Country:US
Practice Address - Phone:352-871-7787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8503101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health