Provider Demographics
NPI:1891045597
Name:TARVER, MEGAN (LPCA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:TARVER
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3661
Mailing Address - Country:US
Mailing Address - Phone:336-273-4687
Mailing Address - Fax:336-333-2444
Practice Address - Street 1:309 CONCORD ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3661
Practice Address - Country:US
Practice Address - Phone:336-273-4687
Practice Address - Fax:336-333-2444
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health