Provider Demographics
NPI:1730647801
Name:HARRISON, MEGAN NICOLE (LMFT 96731)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:NICOLE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LMFT 96731
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 S SPRING ST UNIT 13308
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-3215
Mailing Address - Country:US
Mailing Address - Phone:951-813-1682
Mailing Address - Fax:
Practice Address - Street 1:5520 WELLESLEY ST STE 100
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-4401
Practice Address - Country:US
Practice Address - Phone:619-466-0547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT96731101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health