Provider Demographics
NPI:1760920680
Name:SMYTHE, MEGHAN (MA, MFT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:SMYTHE
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 RUBY CREST DR APT 4306
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-8831
Mailing Address - Country:US
Mailing Address - Phone:484-854-1317
Mailing Address - Fax:
Practice Address - Street 1:555 2ND AVENUE
Practice Address - Street 2:BUILDING B, SUITE 200
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3600
Practice Address - Country:US
Practice Address - Phone:484-854-1317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional