Provider Demographics
NPI:1932304557
Name:ADCOCK, MEGAN M (LMLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:M
Last Name:ADCOCK
Suffix:
Gender:F
Credentials:LMLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-2449
Mailing Address - Country:US
Mailing Address - Phone:620-343-2211
Mailing Address - Fax:620-342-1021
Practice Address - Street 1:1000 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2449
Practice Address - Country:US
Practice Address - Phone:620-343-2211
Practice Address - Fax:620-342-1021
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1101103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist