Provider Demographics
NPI:1821565482
Name:KASIC, MEGAN REBEKA (MA, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:REBEKA
Last Name:KASIC
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:REBEKA
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:3277 FOX CHASE CIR N APT 208
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-2302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3277 FOX CHASE CIR N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-2349
Practice Address - Country:US
Practice Address - Phone:727-314-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH17724101YM0800X
FLMH18776101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health