Provider Demographics
NPI:1851816581
Name:SCHIMPF-PETERSON, MEGAN AILEEN (CADC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:AILEEN
Last Name:SCHIMPF-PETERSON
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 SULLIVAN TRL # 126
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8333
Mailing Address - Country:US
Mailing Address - Phone:570-212-9222
Mailing Address - Fax:
Practice Address - Street 1:204 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77399-2004
Practice Address - Country:US
Practice Address - Phone:570-691-6347
Practice Address - Fax:570-691-6347
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)